儿童过敏性紫癜急性期免疫状态研究

研究儿童过敏性紫癜（HSP）急性期免疫球蛋白与淋巴细胞亚群的变化，探讨其临床意义。方法　研究对象为2006年1月至2007年8月在苏州大学附属儿童医院住院的HSP急性期患儿40例，根据临床有无肾脏损害分为肾炎（HSPN）组和非肾炎（NHSPN）组，各20例，并以20名正常儿童作为对照组，采用速率散射比浊法测定免疫球蛋白IgA、IgG、IgM，采用流式细胞仪分析技术检测外周血单个核细胞CD3+、CD4+、CD8+、CD4+/CD8+、CD19+、CD19+23+、CD16+56+、CD4+CD25+等淋巴细胞亚群的水平。结果　HSPN组与NHSPN组外周血单个核细胞CD3+、CD4+、CD4+/CD8+、CD4+CD25+、CD16+56+水平明显下降， 两组分别与正常对照组比较差异有统计学意义（P < 0.01）；CD8+、CD19+、CD19+23+水平明显上升，两组分别与正常对照组比较差异有统计学意义（P < 0.01）；HSPN组与NHSPN组淋巴细胞亚群组间对比无统计学意义（P > 0.05）；血清免疫球蛋白IgA明显上升，HSPN组与NHSPN组分别与正常对照组比较差异有统计学意义（P < 0.01）；NHSPN组IgG、IgM变化不大，与对照组比较差异无统计学意义（P > 0.05）；HSPN组IgG降低与对照组比较差异有统计学意义（P < 0.05），IgM变化不大，与对照组比较差异无统计学意义（P > 0.05）。结论　HSP患儿急性期B淋巴细胞呈多克隆活化，抗体分泌增多，这为临床采取相应的免疫调节治疗提供了理论依据。

Research on immune state of children with Henoch-Schonleinin acute in phase.

Objective　To observe the changes of the functional states of lymphocyte subgroup and immunoglobulin level of children with Henoch-Schonlein（HSP）in acute phase， and to evaluate its mechanisms in the pathogenesis of HSP and their clinical significance. Methods　Forty HSP patients were divided into the group of Henoch-Schonlein purpura nephritis（HSPN）and the group of non-HSPN. The control group consisted of 20 healthy children. The plasma immunoglobulin IgA、 IgG and IgM were detected with nephelometer and lymphocyte subgroup CD3+、CD4+、CD8+、CD4+/CD8+、CD19+、CD19+23+、CD16+CD56+、CD4+/CD8+ and CD4+CD25+cell were detected with flow cytometry. Results　The contents of CD3+、CD4+、CD4+CD25+、CD16+CD56+ cell and the ratio of group CD4+/CD8+ cell in HSP group were significantly lower than that in control group （P < 0.01）.The contents of CD8+、CD19+、CD19+23+ cell in HSP group were significantly higher than that in control group（P < 0.01）. There was also no significant difference in the levels of lymphocyte subgroup between HSPN group and control group（P > 0.05）. However， the levels of IgA in HSPN group was significantly higher than that in control group（P < 0.01）. There was no significant difference in the levels of IgG and IgM between non-HSP group and control group （P > 0.05）.There was significant difference in the levels of IgG （P <0.05），and no significant difference between HSPN and non-HSPN（P > 0.05）. Conclusion　The results show that there is a polyclonal B cell activation characterized by significantly increased IgA in HSPN and NHSPN， which provides objective index and theoretical evidences for dignosis and treatment of HSP.