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目的观察原发性肾病综合征(PNS)患儿采用槐杞黄颗粒辅助治疗前后T调节细胞(Treg细胞)及IL-10水平的变化。方法 PNS患儿59例。随机将其分为泼尼松联合槐杞黄颗粒治疗组32例(A组),单纯泼尼松治疗组27例(B组)。观察治疗前和治疗3个月其外周血CD4+CD25+Foxp3+Treg(Foxp3+Treg)细胞数量及IL-10的变化。同时选取体检健康儿童10名为健康对照组(C组)。采用流式细胞仪检测PNS患儿外周血单核细胞中Foxp3+Treg细胞/CD4+细胞的百分比,结合血常规计算Treg细胞数量,采用酶联免疫吸附法测定其血浆IL-10水平。结果 1.Foxp3+Treg细胞:治疗前A、B组血Foxp3+Treg细胞/CD4+细胞百分比、Foxp3+Treg细胞数量均低于C组(Pa<0.01);治疗3个月A、B组Treg细胞/CD4+百分比较治疗前均明显升高(Pa<0.01),但仍低于C组(Pa<0.01),A、B两组间差异无统计学意义;治疗3个月A组Foxp3+Treg细胞数目较治疗前及B组治疗后明显升高(P<0.01),但仍显著低于C组(P<0.01),B组Foxp3+Treg数目较治疗前升高不明显(P>0.05)。2.治疗前A、B组IL-10水平均低于C组(Pa<0.05),A组治疗3个月IL-10水平明显高于B组(P<0.01),仍未达C组水平。结论 Foxp3+Treg细胞数量下降及分泌IL-10减少可能参与PNS的发病,而槐杞黄颗粒可通过提高Foxp3+Treg细胞数量而发挥PNS患儿的免疫调节作用。
Objective To observe the changes of T regulatory cells (Tregs) and IL-10 levels in children with primary nephrotic syndrome (PNS) before and after the Huaiqi Huang granules adjuvant therapy. Methods 59 cases of PNS children. Randomly divided into prednisone with Huai Qi Huang granules treatment group of 32 patients (group A), prednisone treatment group of 27 patients (group B). The changes of CD4 + CD25 + Foxp3 + Treg (Foxp3 + Treg) cells and IL-10 in peripheral blood before and 3 months after treatment were observed. At the same time, 10 healthy children were selected as healthy control group (C group). The percentage of Foxp3 + Treg cells / CD4 + cells in peripheral blood mononuclear cells of children with PNS was detected by flow cytometry, the number of Treg cells was calculated by the combination of blood routine, and the level of plasma IL-10 was measured by enzyme-linked immunosorbent assay. Foxp3 + Treg cells: The percentage of Foxp3 + Treg cells / CD4 + cells and the number of Foxp3 + Treg cells in group A and B before treatment were significantly lower than those in group C (P <0.01) / CD4 + were significantly higher than those before treatment (Pa <0.01), but still lower than those in group C (Pa <0.01). There was no significant difference between A and B groups after 3 months of treatment. Foxp3 + Treg cells The number of Foxp3 + Tregs in group B was significantly higher than that before treatment (P <0.01), but was still significantly lower than that in group C (P <0.01). The level of IL-10 in group A and B before treatment was significantly lower than that in group C (P <0.05), and the level of IL-10 in group A at 3 months was significantly higher than that in group B (P <0.01) . Conclusion The decrease of Foxp3 + Treg cells and the decrease of secretion of IL-10 may be involved in the pathogenesis of PNS. Huaiqi Huang granules can play an immunomodulatory role in PNS children by increasing the number of Foxp3 + Treg cells.