Relative Research Of Immunology Between Primary Nephrotic Syndrome And Infection

Nephrotic syndrome (NS) is a group of clinical syndrome that ischaracterized by massive albuminuria, hypoalbuminaemia, edema andhyperlipidemia. It may cause by multiple etiological factors andpatho-categories. We traditional dividatur it into primary nephrotic syndrome(PNS) and that continued from other disease. This disease is belongs to thecaregory of edema of Traditional Chinese Medicine (TCM). This article mainlyaims at the adult primary nephrotic syndrome to study. From retrospectivereviewing, we try to find out the relationship between the disease and infection,dangerous factor of infection and the effect of the immunopotentiation therapy.We try to offer objective index of TCM clinical determination of treatmentbased on the differentiation of symptoms and signs. And we can direct clinicaltherapy, shorten length of stay, lessen infection and disease recur, abatementpatient's suffering, elevate quality of life.There are 75 cases in this research. All the patients are in hospital ofChina-Japan Union hospital of Jilin University that final diagnosis is PNS, themale are 36 cases, and the females are 39, the age of them is from 16 to 73, theaverage age is 36.4, the cause from 3 days to 14 years, the average is 11 months.We record and make statistical treatment to the hospital day, condition relieftime, serum albumin (ALB), immune globulin (IG), complement, Urinary protin(UPRO), admission and duration of hospital stay according to the difference ofgender, concurrent infection, immunopotentiation therapy, and combining withTCM differentiation of symptoms and signs.The result: infection has relation with adult PNS's happen and recur, invarious infections, urinary tract infection patients are multitude;infection hasmain factor with hypoimmunoglobuline, massive albuminuria,hypoalbuminaemia;and after ALB≤25g/L,Urine protein>5.0g/24h, the ratioof concurrent infection increased obviously;immunopotentiation therapy isgood to infection prevention;in north, yin edema patients are multitude, andtheir immune function are better than yin edema's. immunopotentiation therapycan shorten the length of stay of yin edema patients.TCM deems that edema is the appearance of hypofuction of vital energy allover the body. It is mainly due to lung, spleen and kidney. All kinds of factors,either exogenous pathogenic factor or internal damage can cause functionaldisorder of these three organs, malfunction of functioning of the urinary bladder,triple watmer dysfunction, than formn edema. We analyse and differentiatepathological conditions in accordance with yin and yang. Yang edema mainlycaused by wind-evil, edema, damp toxin, wetness-heat evil and so on, whichappears superficies, heat and sthenia syndrome. Yin edema mainly caused byimproper diet and overtiredness, excess of sexual intercourse, healthy energydamaging, which appears interior, cold, asthenia.In immunopotentiation therapy, main Chinese materia medicas areCordyceps sinensis, Milkvetch root, Epimedium and Chinese angelica.Cordyceps sinensis can tonifying kidney and strengthen, invigorate the lung andrelieve dyspnea, hemostasis and eliminate sputum. Research indicate that it canelevate enzymatic active, improve RBC quality and quantity, elevate IL-1activity, increase IL-2 yield, and has immune function up-regulation effect. Italso can enhance MPS function and T cell, B cell and NK activity, improvenon-specificity and specificity immunity to prevent infection. Milkvetch roothas invigorating vital energy and splenic yang, supplement wei-energy to protectbody, inducing diuresis to alleviate edema, Suppurative sore and sarcogeniceffect. Research indicate that it can elevate T cell and B cell activity, increaseIgG, IgA, CD3, CD4, CD3/CD4, enhance MP, NK activity to improvenon-specific immunity. It also can raise ALB level, improve organism nutritionalstate. Epimedium can warm kidney to invigorate yang, strengthen bones andmuscles, expel wind and wetness. Research indicate that it can enhance nucleateand protein synthesis of yang asthenia animal, and has androgen-like action, canelevate organism immune function, especially to renal deficiency patient.Chinese angelica can enrich, promoting blood flow, regulating menstruation,alleviate pain and aperitive effect. Modern pharmacology said that it can elevateT cell and CD4+T cell ratio, and has immune enhancement effect. It also haseffect of rivalry immune function depressant that come from cyclophosphamide.Modern medicine consider that primary glomcrulus disease mainetiopathogenesis is immune system disfunction. CIC and ISIC deposit atglomcrulus, stimulate T cell and MPS to product various kinds of cytokine, suchas IL-1,2,6,8, TNF, and so on. It can aggravate glomcrulus damage. So peoplegive more close attention to immune change of NS.As one of NS complication, infection has galactic influence to thetherapeutic efficacy and prognosis, and received more attention. Some studyshow that infection has relations to hypoimmunity, length of stay and the usingof immune depressant. Immunopotentiation therapy and shorten the length ofstay may induce the ratio of infection. Clinical data said that low doseintravenous immune globulin or blood plasma can advance IgG, improvepatient's immune state and prevent infection in some degree.As mentioned above, PNS patients have immune function depressed ofdifferent level, and it may cause various kinds of infection to induce NS takeplace and recur, influence the therapeutic efficacy and prognosis. It may haverelative with the using of excitatory and immune depressant, immune globulincomposition low, hypoalbuminaemia and massive albuminuria. Research saidthat immunopotentiation therapy has effect, but the curative effect can't bewholly confirmed, and still has no applicability. This study indicated that not allpatients fit this kind of therapy. From this article we can know yin edema patientsuit the therapy, and it can shorten the length of stay and condition relief. So weshould justify yin or yang edema first and to choose propotional therapeuticregimen. Research had said that shorten length of stay can reduce the ratio ofinfection to improve therapeutic efficacy and prognosis, and we can concludethat it is signidicant to give immunopotentiation therapy to yin edema patient.Because after ALB≤25g/L,Urine protein>5.0g/24h, the ratio of concurrentinfection increased, we may use it to do a indicatio of immunopotentiationtherapy.