阿法骨化醇对儿童过敏性紫癜免疫功能的影响及疗效观察

Effects of Alfacalcidol on Immun Function in Children with Henoch-schonlein Purpura and Observation of Clinical Efficacy

关键词:  阿法骨化醇  过敏性紫癜  细胞免疫  疗效

Key words:  alfacalcidol  henoch-schonlein purpura  cellular immunity  clinical effect

摘要:

目的 观察阿法骨化醇对过敏性紫癜（henoch-schonlein purpura，HSP）患儿免疫功能及临床疗效的影响。方法 选择60例HSP患儿随机分为阿法骨化醇组和常规治疗组，各30例，2组患儿均给予常规治疗，阿法骨化醇组加用阿法骨化醇口服。检测所有患儿治疗前及治疗1月后Th17/Treg细胞比例及血清1，25（OH）₂ D₃、IL-10、IL-17及MMP-9水平。比较2组患儿的临床疗效。结果 治疗后2组患儿Th17细胞比例均有下降（P<0.01），Treg细胞比例均有上升（P<0.01），阿法骨化醇组变化更明显。治疗后，阿法骨化醇组血清1，25（OH）₂ D₃水平较常规治疗组升高（P<0.01），血清IL-10、IL-17及MMP-9水平较常规治疗组降低（P<0.01）。阿法骨化醇组的腹痛、关节肿痛、肾脏病变消退时间及半年内复发次数优于常规治疗组（P<0.05）。结论 阿法骨化醇能改善HSP患儿免疫功能，对HSP患儿有效，但需更多研究进一步证实。

Abstract:

OBJECTIVE To investigate the effects of alfacalcidol on immun function and clinical efficacy in children with henoch-schonlein purpura (HSP). METHODS Sixty cases of HSP were selected and randomly divided into the alfacalcidol treatment group and the conventional treatment group, 30 cases in each group. The conventional treatment group was given the routine therapy, while the alfacalcidol treatment group was added alfacalcidol oral on the basis of the routine therapy. The peripheral frequence of Th17 cell and Treg cell of all the objects (before treatment and after 1 month treatment) were detected, and the serum concentrations of 1,25- (OH)₂ D₃, IL-10, IL-17 and MMP-9 were also detected. The clinical efficacy and symptom control time were compared between two groups. RESULTS Compared with pre-treatment, the proportion of Th17 cell were decreased significantly and the proportion of Treg cell were increased significantly after treatment, all those difference were significantly (P<0.01). The alfacalcidol treatment group had a significant change compared with the conventional treatment group. After treatment, the serum of 1,25- (OH)₂ D₃ in the alfacalcidol treatment group was higher than the convntional treatment group (P<0.01), while the serum of IL-10, IL-17 and MMP-9 levels were significantly reduced (P<0.01). The alfacalcidol treatment group was superior to the conventional treatment group in abdominal pain, joint swelling and pain, renal lesion regression time and recurrence times within half a year (P<0.05). CONCLUSION Alfacalcidol can improve the immune function of children with HSP, and it has a certain clinical efficacy, but more research is need to prove.