本文選題：過敏性紫癜 + 復(fù)方甘草酸苷　； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：第一部分復(fù)方甘草酸苷對(duì)兒童過敏性紫癜Th17/Treg細(xì)胞免疫的影響 目的：探討復(fù)方甘草酸苷(compound glycyrrhizin，GL)治療兒童過敏性紫癜(Henoch-Schonlein purpura, HSP)的臨床療效，以及對(duì)外周血Treg、Th17細(xì)胞免疫的影響。 方法：采集我院腎臟免疫科住院治療的27例初發(fā)HSP病人作為治療組，另26例HSP患兒作為疾病對(duì)照組；于兒童保健門診收集25例健康兒童作為正常對(duì)照組。治療組在疾病對(duì)照組的基礎(chǔ)上增加復(fù)方甘草酸苷(0.5-2ml/kg)iv*7天治療；留取治療前后外周血單個(gè)核細(xì)胞行流式細(xì)胞術(shù)檢測(cè)Treg、Th17細(xì)胞陽(yáng)性率。 結(jié)果：1.臨床癥狀：治療組皮疹消退時(shí)間較疾病對(duì)照組有縮短趨勢(shì)，，且腎損害有緩解，1月內(nèi)紫癜復(fù)發(fā)率低；2.Treg、Th17細(xì)胞比例：治療組治療前Treg細(xì)胞陽(yáng)性率低于正常對(duì)照組(P=0.010)；治療后與正常對(duì)照組無統(tǒng)計(jì)學(xué)差異(P=0.059)；疾病對(duì)照組治療后Treg低于治療前及正常對(duì)照組(P=0.006，P=0.013)。治療組治療前Th17細(xì)胞陽(yáng)性率高于治療后及正常對(duì)照組水平(P=0.024，P=0.013)；治療后Th17與正常對(duì)照組無差異(P=0.337)。疾病對(duì)照組治療前Th17亦顯著高于治療后水平(P=0.014)。 結(jié)論：1.GL治療兒童HSP，可減輕腎損害、短期內(nèi)減少紫癜復(fù)發(fā)。2.HSP患兒急性期，具有促炎作用的Th17和抗炎作用的Treg可能共同參與其免疫發(fā)病。3.GL具有下調(diào)Th17、上調(diào)Treg細(xì)胞比例的作用，提示GL可能具有一定T細(xì)胞免疫調(diào)節(jié)功能，在佐治兒童HSP免疫炎癥方面有一定療效。 第二部分復(fù)方甘草酸苷對(duì)兒童過敏性紫癜血漿IL-17、TNF-α、IP-10、IFN-γ水平的影響 目的：從促炎因子IL-17、TNF-α、IP-10、IFN-γ水平探討復(fù)方甘草酸苷(compound glycyrrhizin， GL)治療兒童過敏性紫癜(Henoch-Schonlein purpura, HSP)的免疫學(xué)機(jī)制。 方法：采集我院腎臟免疫科住院治療的27例初發(fā)HSP病人作為治療組，另26例HSP患兒作為疾病對(duì)照組；同時(shí)于兒童保健門診收集25例健康兒童作為正常對(duì)照組。治療組在疾病對(duì)照組的基礎(chǔ)上增加復(fù)方甘草酸苷(0.5-2ml/kg)iv*7天治療；ELISA法檢測(cè)患兒血漿中促炎因子TNF-α、IP-10、IL-17、IFN-γ的濃度變化。 結(jié)果：1.兩組HSP治療前血漿IL-17、IFN-γ濃度均高于正常對(duì)照組水平(P=0.013，P=0.010)；治療組治療后IL-17、IFN-γ濃度與正常對(duì)照組無統(tǒng)計(jì)學(xué)差異(P=0.052，P=0.154)，疾病對(duì)照組治療后仍顯著高于正常對(duì)照組(P=0.000，P=0.000)。2.治療組治療前血漿TNF-α、IP-10均高于治療后水平(P=0.011，P=0.037)，疾病對(duì)照組治療前后兩指標(biāo)無統(tǒng)計(jì)學(xué)差異(P=0.247，P=0.709)。 結(jié)論：GL具有降低HSP患兒血漿IL-17、IFN-γ、TNF-α、IP-10水平的作用，在佐治兒童HSP免疫炎癥方面有一定療效。
[Abstract]:Part one the effect of compound glycyrrhizin on Th17 / Treg cell immunity in children with Henoch-Schonlein purpura (HSP). Objective: to investigate the clinical effect of compound glycyrrhizin GLL on Henoch-Schonlein purpura (HSPs) in children with Henoch-Schonlein purpura (HSP). Methods: 27 patients with primary HSP were selected as treatment group and 26 children with HSP as control group. 25 healthy children were collected as normal control group. The patients in the treatment group were treated with compound glycyrrhizin 0.5-2ml / kg iv for 7 days, and the positive rate of TregTh17 cells was detected by flow cytometry before and after the treatment. Clinical symptoms: in treatment group, the time of rash subsiding was shorter than that in control group. The renal damage was alleviated and the recurrence rate of purpura was low within 1 month. 2. Proportion of Tregg Th17 cells: the positive rate of Treg cells in the treatment group was lower than that in the normal control group before treatment, the positive rate of Treg cells in the treatment group was lower than that in the normal control group, there was no statistical difference between the treatment group and the normal control group, and the Treg level in the disease control group was lower than that in the control group after treatment. Before treatment and normal control group, P0. 006 and P0. 013. The positive rate of Th17 cells in treatment group was higher than that after treatment and normal control group, but there was no difference between Th17 and normal control group after treatment. Th17 was also significantly higher in the disease control group before and after treatment than that in the post-treatment group. Conclusion the treatment of children with HSP1 / GL can reduce renal damage and decrease the recurrence of Henoch-Schonlein purpura at the acute stage of HSP in a short period of time. Th17 with proinflammatory effect and Treg with anti-inflammatory action may be involved in its immunopathogenesis. 3.GL can down-regulate Th17 and up-regulate the proportion of Treg cells, suggesting that GL may have the function of T cell immunomodulation. Part 2 effect of compound glycyrrhizin on plasma IL-17 TNF- 偽 IP-10 IFN- 緯 level in children with allergic purpura: objective: to explore the effect of compound glycyrrhizin (GLL) on the level of IL-17 TNF- 偽 IP-10 IFN- 緯 in children with HSP. The immunological mechanism of Henoch-Schonlein purpura (HSP) in children with Henoch-Schonlein purpura (HSP). Another 26 children with HSP served as disease control group and 25 healthy children as normal control group. In the treatment group, the concentration of TNF- 偽, IP-10, IL-17 and IFN- 緯 in plasma was detected by Elisa on the basis of adding compound glycyrrhizin 0.5-2ml / kg iv for 7 days. Before and after treatment, the plasma levels of IL-17 and IFN- 緯 in the two groups were higher than those in the normal control group, but there was no significant difference between the treatment group and the normal control group in the concentration of IL-17, IFN- 緯, and the level of IL-17, IFN- 緯 in the treatment group was still significantly higher than that in the normal control group after treatment, and there was no significant difference between the treatment group and the normal control group in the level of IL-17 and IFN- 緯. After treatment, the level of IL-17 was still significantly higher than that in the normal control group. The plasma levels of TNF- 偽 and IP-10 before and after treatment were higher in the treatment group than in the post-treatment group, and there was no significant difference between the two indexes before and after treatment in the disease control group. Conclusion the level of IL-17- IFN- 緯 TNF- 偽 IP-10 in plasma of children with HSP can be reduced by the use of TNF- 偽-10 in the treatment group, and there is a certain therapeutic effect in the adjuvant treatment of HSP- immune inflammation in children with HSP.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R725.5

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本文編號(hào)：1988027