血液灌流治疗小儿过敏性紫癜的疗效及对凝血功能、炎症因子及免疫功能的影响
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摘要
目的探讨对小儿过敏性紫癜行血液灌流治疗的效果和对患儿免疫功能、炎症因子以及凝血功能的影响。方法选取我院2017年4月至2018年6月收治的过敏性紫癜患儿86例,按照随机数字表法分为对照组和研究组各43例。对照组给予常规治疗,研究组在此基础上行血液灌流治疗。观察比较两组患儿免疫功能、炎症因子、凝血功能以及治疗效果。结果研究组患儿住院、关节疼痛、便血缓解、腹痛缓解以及紫癜消退时间均少于对照组(P <0. 05);治疗后研究组患儿FIB低于对照组,PT及APTT高于对照组,炎症因子IL-10、IL-6、TNF-α低于对照组,免疫指标CD4~+、CD3~+高于对照组,差异均有统计学意义(P <0. 05)。两组患儿CD4~+/CD8~+、CD8~+差异无统计学意义(P> 0. 05)。结论应用血液灌流治疗过敏性紫癜的效果更佳,能使患儿的炎症因子、免疫功能以及凝血功能得到有效改善,值得推广及应用。
Objective To explore the therapeutic effect of hemoperfusion in the treatment of allergic purpura in children and the effect of this method on immune function,inflammatory factors and coagulation function.Methods We selected 86 children with allergic purpura admitted to our hospital from April 2017 to June 2018.The patients were divided into control or study group according to the random number table,43 in each group.The control group was given routine treatment,while the study group was treated by combining conventional methods with blood perfusion.The immune function,inflammatory factors,coagulation function and therapeutic effect were compared between the two groups.Results The duration of hospitalization,joint pain,hemafuria relief,abdominal pain relief and time of purpura subsiding in the study group was less than those in the control group( P < 0. 05). After treatment,FIB in the study group was significantly lower than that in the control group,and PT and APTT were higher than those in the control group( P < 0. 05).The inflammatory factors such as IL-10,IL-6 and TNF-in the study group were significantly lower than those in the control group( P <0. 05).The indexes of immune function such as CD4+ and CD3+ in the study group were significantly higher than those in the control group( P < 0. 05),while there was no significant difference in CD4+/CD8+ and CD8+ between the two groups( P > 0. 05).Conclusion Hemoperfusion is more effective in treating allergic purpura in children,and can effectively improve the inflammatory factors,immune function and coagulation function of the patients.
Objective To explore the therapeutic effect of hemoperfusion in the treatment of allergic purpura in children and the effect of this method on immune function,inflammatory factors and coagulation function.Methods We selected 86 children with allergic purpura admitted to our hospital from April 2017 to June 2018.The patients were divided into control or study group according to the random number table,43 in each group.The control group was given routine treatment,while the study group was treated by combining conventional methods with blood perfusion.The immune function,inflammatory factors,coagulation function and therapeutic effect were compared between the two groups.Results The duration of hospitalization,joint pain,hemafuria relief,abdominal pain relief and time of purpura subsiding in the study group was less than those in the control group( P < 0. 05). After treatment,FIB in the study group was significantly lower than that in the control group,and PT and APTT were higher than those in the control group( P < 0. 05).The inflammatory factors such as IL-10,IL-6 and TNF-in the study group were significantly lower than those in the control group( P <0. 05).The indexes of immune function such as CD4+ and CD3+ in the study group were significantly higher than those in the control group( P < 0. 05),while there was no significant difference in CD4+/CD8+ and CD8+ between the two groups( P > 0. 05).Conclusion Hemoperfusion is more effective in treating allergic purpura in children,and can effectively improve the inflammatory factors,immune function and coagulation function of the patients.
引文
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[11]邹珊珊,杨蕊铭,何韶衡.过敏性紫癜患者血液嗜酸性粒细胞IL-18和IL-18受体表达升高[J].免疫学杂志,2017,12(12):1034-1039.
[12]Picarelli A,Puzzono M,Borghini R,et al. Mo1222 Usefulness of Laser Doppler Perfusion Imaging to Objectify the Oral Mucosa Patch Test in the Diagnosis of Allergic Contact Mucositis to Nickel[J].Gastroenterology,2015,148(4):S-642-S-642.
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[14]Broomfield A,Jones SA,Hughes SM,et al.The impact of the immune system on the safety and efficiency of enzyme replacement therapy in lysosomal storage disorders[J]. Journal of Inherited Metabolic Disease,2016,39(4):499-512.
[15]李涛,邓芳,张晓翠,等.血管紧张素原在儿童过敏性紫癜肾炎发生发展中的作用[J].中国现代医学杂志,2017,27(16):53-57.
[2]张焱,高峰.血液透析滤过与血液透析联合血液灌流治疗尿毒症顽固性高血压的疗效比较[J].中国中西医结合急救杂志,2016,23(2):203-204.
[3]Jeancharles PY,Zhang L,Wu JH,et al. Ubiquitin-specific Protease20 Regulates the Reciprocal Functions ofβ-Arrestin2 in Toll-like Receptor 4-promoted Nuclear FactorκB(NFκB)Activation[J].Journal of Biological Chemistry,2016,291(14):7450-7451.
[4]李玉峰,云蕾,周丽江,等.静脉滴注丙种球蛋白治疗儿童过敏性紫癜不良反应观察及预防性护理[J].重庆医学,2017,46(3):425-426.
[5]李沫民,柳旎,张淼,等.过敏性紫癜患儿血清中期因子变化的临床意义[J].中国实验血液学杂志,2017,25(1):181-185.
[6]Miller CM,Donner AJ,Blank EE,et al.Stabilin-1 and Stabilin-2 are specific receptors for the cellular internalization of phosphorothioatemodified antisense oligonucleotides(ASOs)in the liver[J].Nucleic Acids Research,2016,44(6):2782-2783.
[7]冯云生,黄兰,赵亚娟,等.血液透析联合血液灌流治疗对ESDN患者胰岛素抵抗、血清炎症因子及营养状况的影响[J].山东医药,2016,56(25):92-94..
[8]张灵灵.血液透析联合血液灌流治疗老年血液透析合并慢性肾脏病矿物质和骨代谢异常的效果及对BMP、i PTH、甲状腺素水平的影响[J].中国老年学杂志,2018,38(9):125-127.
[9]Petek BJ,Bravo PE,Kim F,et al. Incidence and Risk Factors for Postcontrast Acute Kidney Injury in Survivors of Sudden Cardiac Arrest.[J].Annals of Emergency Medicine,2016,67(4):469-476.
[10]王宝香,梅红,彭罕鸣,等.纤溶酶原激活物抑制因子1基因多态性与过敏性紫癜胃肠道出血的相关性[J].临床儿科杂志,2016,34(3):197-200.
[11]邹珊珊,杨蕊铭,何韶衡.过敏性紫癜患者血液嗜酸性粒细胞IL-18和IL-18受体表达升高[J].免疫学杂志,2017,12(12):1034-1039.
[12]Picarelli A,Puzzono M,Borghini R,et al. Mo1222 Usefulness of Laser Doppler Perfusion Imaging to Objectify the Oral Mucosa Patch Test in the Diagnosis of Allergic Contact Mucositis to Nickel[J].Gastroenterology,2015,148(4):S-642-S-642.
[13]王菲,董丽丽.过敏性紫癜患儿血清中IL-33和可溶性受体的水平及其临床意义[J].中国实验血液学杂志,2017,25(2):517-521.
[14]Broomfield A,Jones SA,Hughes SM,et al.The impact of the immune system on the safety and efficiency of enzyme replacement therapy in lysosomal storage disorders[J]. Journal of Inherited Metabolic Disease,2016,39(4):499-512.
[15]李涛,邓芳,张晓翠,等.血管紧张素原在儿童过敏性紫癜肾炎发生发展中的作用[J].中国现代医学杂志,2017,27(16):53-57.