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目的 通过对外周血淋巴细胞糖皮质激素受体 (GCR)测定 ,探讨GCR与儿童过敏性紫癜发病及预后的关系。方法 采用完整细胞放射配基结合分析法测定 35例过敏性紫癜初始发病儿童的外周血淋巴细胞GCR。结果 过敏性紫癜儿童外周血淋巴细胞GCR为 30 6 0± 2 15 3结合位点/细胞 ,低于正常儿童外周血淋巴细胞GCR(5 2 10± 16 39结合位点 /细胞 ) (t=7.4 P <0 .0 0 1)。 18例随访 1a以上。复发5例 ,复发者GCR水平低于未复发者。复发者中 1例初始病程长达 4个月 ,1a中复发 3次 ,其GCR仅为 12 7结合位点 /细胞。 14例并紫癜性肾炎与无肾损害患儿GCR水平无显著差别。结论 过敏性紫癜儿童淋巴细胞GCR水平下降 ,可能与本病的免疫病损发生有关 ;GCR水平明显下降可能预示疾病预后差 ,易复发
Objective To investigate the relationship between GCR and the incidence and prognosis of childhood Henoch-Schonlein purpura by measuring the peripheral blood lymphocyte glucocorticoid receptor (GCR). Methods Whole cell radioligand binding assay was used to determine the GCR of peripheral blood lymphocytes in 35 children with initial onset of Henoch-Schonlein purpura. Results The GCR of peripheral blood lymphocytes of children with allergic purpura was 30 60 ± 2 15 3 binding sites / cell, which was lower than that of normal children (5 2 10 ± 16 39 binding sites / cell) (t = 7.4 P <0 0 0 1). 18 cases were followed for more than 1a. Recurrence in 5 cases, the recurrence of GCR levels were lower than those without recurrence. One patient in the relapse had an initial course of up to 4 months and a relapse of 3 times in 1a with a GCR of only 12 7 binding sites per cell. There was no significant difference in GCR level among 14 cases with purpura nephritis and without renal damage. Conclusion The decrease of GCR in lymphocytes of children with Henoch-Schonlein purpura may be related to the immunopathological changes of this disease. The significant decrease of GCR may indicate poor prognosis and relapse