Immunological Characteristics And Intervention Of Children With Henoch-Schonlein Purpura

OBJECTIVE:To explore the possible pathogenesis of Henoch-Schonlein purpura(HSP)in children by analyzing the characteristics of humoral and cellular immunity during the acute phase of HSP in children and to observe its intervention effect.METHODS:A total of 204 HSP children hospitalized in The Second Hospital of Dalian Medical University from January 2013 to December 2017 were selected.According to whether or not the kidneys were affected,they were divided into HSPN group and non-nephritic group(non-HSPN group).The healthy control group consisted of 113 healthy children in the same period.The levels of serum immunoglobulins(IgA,IgE,IgM,IgG)and lymphocyte subsets in all children were measured.Among them,91 cases of children from July 2015 to June 2017 were divided into two groups by random number table:conventional treatment group(41 cases)and Huaiqi Huang group(50 cases).both groups were given general conventional treatment.Huaiqi Huang group was treated with Huaiqi Huang granules on the basis of routine treatment.Three months later,two groups of children were re-examined for immunoglobulin and lymphocyte subsets.And then,recorded the relapse of children in two groups within 6 months.RESULT:1.Compared with healthy control group,the serum IgA,IgG,CD3+CD8+%and B cell percentage of HSP group were significantly increased,while the CD3+%,CD3+CD4+%and CD4/CD8 were significantly decreased.the differences were statistically significant(P<0.05).IgE,IgM and NK cell percentage in the two groups showed no significant difference(P>0.05).2.Thirty-eight of 204 children with HSP had kidney involvement,the incidence of which was 18.63%.IgA levels in HSPN group were significantly higher than those in non-HSPN group(P=0.001).The incidence ofkidney involvement in HSP patients with elevated serum IgA level(22.54%)was higher than that in normal IgA patients(10.17%),with statistical significance(χ~2=4.157,P<0.05).3.After 3 months of treatment,the IgA and CD3+CD8+%of the two groups decreased(P>0.05),while the CD3+%,CD3+CD4+%and CD4/CD8 increased(P>0.05).The HuaiqiHuang group improved more significantly than the conventional treatment group(P<0.05).4.There was no difference in the relapse rate between two groups of children with HSP in three months of follow up(P>0.05).The relapse rate of 91 cases was 41.76%(38 cases)in six months of follow up,of which the relapse rate was 28.0%(14 cases)in Huai Qi Huang group,significantly lower than 58.54%(24 cases)in conventional treatment group(χ~2=8.637,P<0.05).CONCLUSION:1.The serum levels of IgA and IgG in children with Henoch-Schonlein purpura at acute stage are elevated,suggesting that IgA and IgG may be the major immunoglobulins participating in the pathogenesis of HSP.they have imbalanced proportion of CD4+cells and CD8+cells.2.Elevated serum IgA levels may be an indicator of the occurrence of HSPN.3.Huai Qi Huang can improve the HSP in children with humoral and cellular immune disorders.4.Huai Qi Huang can reduce the recurrence rate of HSP.