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目的观察复方甘草酸苷对过敏性紫癜(HSP)患儿外周血T辅助细胞功能的影响。方法选取急性期HSP患儿39例,随机分为复方甘草酸苷治疗组20例、糖皮质激素治疗组19例,选取22例健康儿童为正常对照组。复方甘草酸苷组在常规治疗基础上给予复方甘草酸苷(3~5岁80mg qd、5~8岁120mg qd、>8岁160mg qd)治疗7~10d,糖皮质激素组在常规治疗基础上给予甲基强的松龙(1~2mg/(kg·d),bid)治疗7~10d。留取治疗前后血浆,采用双抗体夹心酶联免疫吸附(ELISA)法检测血浆干扰素-γ(IFN-γ)、白介素-4(IL-4)、白介素-17(IL-17)水平变化。结果 (1)HSP组患儿治疗前血浆IL-4、IL-17水平明显高于正常对照组(P<0.05,P<0.01),IFN-γ水平与正常对照组无显著性差异(P>0.05);治疗前复方甘草酸苷组与糖皮质激素组血浆IFN-γ、IL-4、IL-17水平均无显著性差异(均P>0.05)。(2)复方甘草酸苷组治疗前后血浆IFN-γ水平变化无显著性差异(P>0.05),而IL-4、IL-17水平治疗后显著降低(P<0.01,P<0.05);糖皮质激素组用药后血浆IFN-γ、IL-4、IL-17水平均较治疗前均显著下降(P<0.05,P<0.01,P<0.05)。(3)糖皮质激素组用药后血浆IFN-γ、IL-4、IL-17水平下降幅度均显著大于复方甘草酸苷组(P均<0.05)。结论复方甘草酸苷可能通过抑制HSP患儿Th2、Th17细胞活化而发挥抗炎和免疫调节作用,但其作用强度不及糖皮质激素明显。
Objective To observe the effects of compound glycyrrhizin on peripheral blood T helper cell function in children with Henoch-Schonlein purpura (HSP). Methods Thirty-nine children with acute HSP were randomly divided into compound glycyrrhizin treatment group (n = 20) and glucocorticoid treatment group (n = 19). 22 healthy children were selected as normal control group. Compound glycyrrhizin group was given compound glycyrrhizin (80 mg qd at 3 ~ 5 years, 120 mg qd at 5 ~ 8 years, 160 mg qd at 8 years old) on the basis of routine treatment for 7 ~ 10 days. On the basis of routine treatment Give methylprednisolone (1 ~ 2mg / (kg · d), bid) for 7 ~ 10d. Plasma samples were collected before and after treatment, and the changes of plasma IFN-γ, IL-4 and IL-17 were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) Results (1) The levels of plasma IL-4 and IL-17 in HSP group before treatment were significantly higher than those in normal control group (P <0.05, P <0.01), while there was no significant difference in IFN-γ level between HSP group and normal control group (P> 0.05). There was no significant difference in plasma IFN-γ, IL-4 and IL-17 levels between compound glycyrrhizin group and glucocorticoid group before treatment (all P> 0.05). (2) There was no significant difference in plasma IFN-γ levels between the compound glycyrrhizin group before and after treatment (P> 0.05), but IL-4 and IL-17 levels were significantly lower after treatment (P <0.01, P < The levels of plasma IFN-γ, IL-4 and IL-17 in the corticosteroid group were significantly lower than those before treatment (P <0.05, P <0.01, P <0.05). (3) The decrease of plasma IFN-γ, IL-4 and IL-17 levels in glucocorticoid group were significantly greater than those in compound glycyrrhizin group (all P <0.05). Conclusion Compound glycyrrhizin may exert anti-inflammatory and immunomodulatory effects by inhibiting the activation of Th2 and Th17 cells in HSP children, but its effect intensity is less than that of glucocorticoid.