儿童气阴两虚型频复发肾病综合征血浆免疫球蛋白与肾病相关指标的分析及意义

发布时间：2018-06-12 00:18

本文选题：气阴两虚 + 频复发　；参考：《南京中医药大学》2012年硕士论文

【摘要】：目的：1.研究气阴两虚型频复发肾病综合征(FRNS)患儿与正常儿童之间血浆免疫球蛋白水平差异,遴选出具有显著性差异的免疫球蛋白种类；2.分析气阴两虚型患儿血浆免疫球蛋白水平,分别与24小时蛋白尿定量、血清白蛋白和血浆胆固醇进行相关性分析,发现可能的特殊免疫状态；3.讨论中医药辨证治疗气阴两虚型频复发肾病综合征的原则与方法,为中医药改善气阴两虚型FRNS特殊免疫状态寻求可能的理论依据。方法：1.选择门诊健康儿童作为正常组,将门诊或住院确诊的气阴两虚型FRNS患儿视为患病组；2.测定J正常组血浆免疫球蛋白(IgG、 IgE、 IgM、 IgA)水平作为对照；测定患病组儿童首次发病时、发病后1-2月和发病后4-7月时血浆免疫球蛋白、24小时尿蛋白定量、血浆白蛋白和血浆胆固醇等进行研究；3.比较正常组与患病组儿童血浆免疫球蛋白差异,遴选差异性显著的免疫球蛋白类型；4.将具有显著差异性的患病组免疫指标分别与24小时蛋白尿定量、血浆白蛋白等进行相关性分析。结果：1.正常儿童与气阴两虚型FRNS患儿首次确诊时一般资料比较,正常组19例,患病组33例,两组间性别和年龄差异无统计学意义；2.血浆IgG患病组与正常组比较具有良好的显著性差异,降低程度明显；患病后4-7月时血浆IgG较患病1-2月时差异性有统计学意义,有所升高；3.血浆IgA患病组与正常组比较具有良好的显著性差异,降低程度明显；患病组内比较差异性无统计学意义；4.血浆IgM、 IgE正常组与患病组间以及患病组内部比较均无统计学意义；5.患病后1-2月和4-7月时,血浆IgG与血清白蛋白具有良好的正向直线相关性,与24小时蛋白尿定量和血浆胆固醇具有良好的负向直线相关性,而首次发病时相关性分析不能认为具有直线关系；6.血浆IgA除首次发病时与血浆白蛋白具有一定的正向直线相关性外,其余组内相关性分析均不能认为具有直线关系。结论：1.气阴两虚型FRNS患儿男/女为2.3/1,发病年龄无显著性差异；2.气阴两虚型FRNS患儿存在免疫球蛋白紊乱现象,血浆IgG和IgA较正常儿童下降明显,IgM和IgE与正常儿童无显著性差异；3.血浆IgG与患病后1-2月和4-7月时,与血清白蛋白具有良好的正向直线相关性,与24小时蛋白尿定量和血浆胆固醇具有良好的负向直线相关性；4.中医药可能会改善气阴两虚型FRNS患儿免疫球蛋白紊乱状态。
[Abstract]:Purpose 1. To study the difference of plasma immunoglobulin levels between children with frequent recurrent nephrotic syndrome (FRNSs) of deficiency of qi and yin and normal children, and to select the type of immunoglobulin with significant difference. The level of plasma immunoglobulin in children with deficiency of qi and yin was analyzed, and the relationship between plasma immunoglobulin and 24 hour proteinuria, serum albumin and plasma cholesterol was analyzed respectively. This paper discusses the principles and methods of treating recurrent nephrotic syndrome of deficiency of qi and yin by differentiation of syndrome and syndrome of TCM, and seeks possible theoretical basis for improving the special immune state of FRNS with deficiency of both qi and yin in TCM. Methods: 1. The healthy children in outpatient clinic were selected as normal group, and the FRNS with deficiency of qi and yin in outpatient or inpatient was regarded as the disease group. The levels of IgG, IgE, IgM, IgA in plasma of J normal group were measured as control group, and the urine protein of 24 hours after the first onset, 1-2 months after onset and 4 to 7 months after onset of the disease in children in the diseased group were measured. Plasma albumin and cholesterol were studied. To compare the difference of plasma immunoglobulin between the normal group and the sick group, and to select the immunoglobulin type with significant difference. The correlation between immunological indexes and 24 hours proteinuria, plasma albumin and so on were analyzed. The results were as follows: 1. There were 19 cases in normal group and 33 cases in disease group. There was no significant difference in sex and age between the two groups. Compared with the normal group, the plasma IgG had a significant difference and a significant decrease, and the difference of plasma IgG between April and July was statistically significant compared with that of the normal group, and it was higher than that of the normal group (P < 0.05). Plasma IgA in the disease group compared with the normal group has a good significant difference, the degree of reduction is obvious, the difference between the disease group has no statistical significance. 4. There was no significant difference in plasma IgM, IgE between the normal group and the diseased group and within the diseased group. There was a good positive linear correlation between plasma IgG and serum albumin, a good negative linear correlation between plasma IgG and 24 hour proteinuria and plasma cholesterol at January-February and April-July after the onset of the disease. However, correlation analysis at the first time of onset could not be regarded as a linear relationship. Except for the positive linear correlation between plasma IgA and plasma albumin at the first time of onset, the correlation analysis in other groups could not be regarded as a linear relationship. The ratio of male to female in FRNS with deficiency of qi and yin was 2.3 / 1, and there was no significant difference in age of onset of FRNS. There was a disturbance of immunoglobulin in children with deficiency of qi and yin, and there was no significant difference in plasma IgG, IgA and IgE between children with FRNS and normal children. There was a good positive linear correlation between plasma IgG and serum albumin in January-February and April-July, and a good negative linear correlation with 24-hour proteinuria and plasma cholesterol. Chinese medicine may improve the immune globulin disorder in children with deficiency of qi and yin.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.91

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