泼尼松治疗婴儿痉挛症的免疫机制研究

发布时间：2018-03-28 19:10

本文选题：婴儿痉挛症　切入点：免疫　出处：《中国当代儿科杂志》2017年10期

【摘要】：目的通过检测泼尼松治疗婴儿痉挛症(IS)患儿前后的免疫功能,探讨泼尼松治疗IS的免疫机制。方法选取30例诊断为IS的患儿为IS组,30例行健康体检婴幼儿为健康对照组。采集IS组患儿经泼尼松治疗前后和健康对照组婴幼儿的空腹静脉血,采用化学发光法检测血清IL-1B、IL-2R、IL-6、IL-8、TNF-α水平;免疫比浊法检测血清免疫球蛋白IgA、IgM、IgG水平;流式细胞术检测T细胞亚群(CD3~+、CD4~+、CD8~+)比例。泼尼松治疗后对所有IS患儿进行临床疗效和脑电图评估。结果治疗前IS组血清IL-2R、IL-8、TNF-α水平高于健康对照组(P0.05)。IS患儿平均每日发作串数分别与IL-2R、IL-8、TNF-α水平呈正相关,平均每日发作总次数与IL-8水平呈正相关,且IL-2R、IL-8、TNF-α水平两两间也呈正相关(P0.05)。30例IS患儿经泼尼松治疗后,19例发作控制,18例脑电图高度失律完全缓解。治疗后IS患儿每日发作串数及每日发作总次数均较治疗前明显下降,DQ值较治疗前改善(P0.05);血清IL-2R、IL-8、TNF-α水平,以及CD4~+比例、CD4~+/CD8~+比值均较治疗前明显下降,CD8~+比例较治疗前升高(P0.05)。结论 IS患儿存在免疫功能紊乱,泼尼松能控制IS患儿痉挛发作的效果可能与其可调节及改善IS患儿免疫紊乱有关。
[Abstract]:Objective to detect the immune function of prednisone before and after treatment of infantile spasticity (ISS). To explore the immunological mechanism of prednisone in the treatment of is, 30 children with is were selected as the healthy control group. The fasting venous blood was collected before and after prednisone treatment in the is group and the infants in the healthy control group before and after prednisone treatment. The levels of IL-1B, IL-2, IL-6 and IL-8 TNF- 伪 were detected by chemiluminescence assay, and the levels of serum IgA- IgM- 伪 were detected by immunoturbidimetric method, and the levels of IgM- 伪 and IgM- 伪 were determined by immunoturbidimetric assay. The percentage of T cell subsets CD3 ~ + CD4 ~ + CD8 ~) was detected by flow cytometry. The clinical efficacy and electroencephalogram (EEG) were evaluated after prednisone treatment. Results before treatment, the serum levels of IL-2RRnIL-8 / TNF- 伪 in the is group were higher than those in the healthy control group (P 0.05). The number of episode strings was positively correlated with the level of IL-8 and TNF- 伪, respectively. The average number of episodes per day was positively correlated with the level of IL-8. There was also a positive correlation between the two levels of IL-2R, IL-8 and TNF- 伪. 30 patients with is were treated with prednisone. After prednisone treatment, there were 19 patients with seizure control and 18 patients with complete remission of electroencephalogram (EEG) loss. After treatment, the number of episodes per day and the total number of episodes per day in the patients with is were significantly higher than those before treatment. Compared with before treatment, DQ was significantly decreased, and serum IL-2RnIL-8 / TNF- 伪 level was improved, and serum IL-2RU IL-8 / TNF- 伪 level was also improved compared with that before treatment. The ratio of CD4- / CD8- / CD4- / CD8- was significantly lower than that before treatment, and the ratio of CD8- / CD8- was significantly higher than that before treatment. Conclusion there is a disorder of immune function in children with is. The effect of prednisone on the control of spasmodic attack in children with is may be related to its adjustability and improvement of immune disorder in children with is.
【作者单位】：江西省儿童医院神经内科;
【基金】：江西省卫生计生委课题(20161119)
【分类号】：R742.1

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