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目的通过观察79例过敏性紫癜(HSP)患儿治疗前后淋巴细胞凋亡情况,进一步阐明淋巴细胞凋亡(LA)在HSP中的表现及与各种治疗效果的关系。方法采用原位末端标记技术,对过敏性紫癜患儿治疗过程中淋巴细胞凋亡分组进行测定,在光学显微镜下观察,计算出凋亡比率,然后将急性期与正常组比较、病情较轻的HSP皮肤型与病情较重的HSP复合型比较、恢复期与正常组比较、常规方法治疗未愈的治疗前后比较、常规方法治疗及加用免疫抑制剂方法的治疗前后比较,各组均采用SPSS统计软件进行t检验统计学处理。结果发现急性期患儿组较正常对照组淋巴细胞凋亡情况有显著延迟(P<0.01),恢复期患儿组较急性期患儿组淋巴细胞凋亡情况有明显改善(P<0.01),恢复期患儿组与正常对照组淋巴细胞凋亡情况无明显的差异(P>0.05),经常规方法痊愈的HSP皮肤型淋巴细胞凋亡延迟情况已得到改善(P<0.01),但急性期未痊愈的HSP复合型淋巴细胞凋亡延迟情况未得到改善(P>0.05),急性期病情较重的HSP复合型较病情较轻的HSP皮肤型淋巴细胞凋亡延迟明显(P<0.05),应用雷公藤、激素、甲氨喋呤等免疫抑制剂后淋巴细胞凋亡加速(P<0.01)。结论急性期过敏性紫癜存在淋巴细胞凋亡的延迟,且症状较重HSP较症状较轻HSP的淋巴细胞凋亡延迟明显;经治疗达临床痊愈的恢复期过敏性紫癜淋巴细胞凋亡情况已达正常水平;常规方法治疗可使症状较轻的HSP淋巴细胞凋亡延迟得以改善,但对症状较重的复合型HSP的病例,须加用免疫抑制剂如雷公藤、激素、甲氨喋呤等使淋巴细胞凋亡加速,从而达到治愈目的。
Objective To investigate the lymphocyte apoptosis in 79 children with Henoch-Schonlein purpura (HSP) before and after treatment, and to further elucidate the relationship between lymphocyte apoptosis (LA) in HSP and various therapeutic effects. Methods Apoptotic lymphocyte subsets in children with Henoch-Schonlein purpura were measured by in situ end-labeling technique. The apoptotic rate was determined under a light microscope. The acute phase was compared with the normal group, and the disease was mild HSP skin type and severe disease HSP complex compared with the recovery period compared with the normal group, the conventional treatment of non-healing before and after treatment compared with conventional methods and plus immunosuppressive therapy before and after treatment, each group were used SPSS Statistical software for t test statistics. The results showed that compared with normal control group, the apoptosis of lymphocytes in children with acute phase was significantly delayed (P <0.01), and the apoptosis of lymphocytes in children with convalescent phase was significantly improved (P <0.01) There was no significant difference in lymphocyte apoptosis between the convalescent group and the normal control group (P> 0.05). The delayed apoptosis of HSP skin lymphocytes recovered by the conventional method was improved (P <0.01), but the acute phase The delayed healing of unhealed HSP complex lymphocytes was not improved (P> 0.05). The apoptosis of severe HSP complex in acute phase was delayed significantly (P <0.05) than that of mild HSP skin lymphoid cells, Application of triptolide, hormone, methotrexate and other immunosuppressive agents accelerated apoptosis of lymphocytes (P <0.01). Conclusions Acute purpura has the delay of lymphocyte apoptosis, and the severe symptoms are more severe than HSP. The apoptosis of lymphocytes in HSP is obviously delayed. The apoptosis rate of convalescent patients with HSP recovered after treatment Normal levels; conventional treatment can make mild symptoms of HSP lymphocyte apoptosis delay can be improved, but severe symptoms of complex HSP cases, plus the use of immunosuppressive agents such as triptolide, hormones, methotrexate, etc. To accelerate the apoptosis of lymphocytes, so as to achieve the purpose of cure.