| Objectives: To explore the curative effect and possible mechanismsof hemoperfusion treatment for patients with severe henoch-schonleinpurpura by observing the changes of clinical manifestations and seruminsulin-like growth factor-1, interleukin-17in severe patients withhenoch-schonlein purpura before and after hemoperfusion treatment.Methods:40cases with severe Henoch-Schonlein purpura were dividedinto two groups:20children in group A were given traditional treatment(anti-inflammation, anti-coagulation, anti-allergic, and symptomatictreatment, etc.); another20children in group B were givenhemoperfusiom and traditional treatment.15health children were innormal control group C. Observed and recorded the changes of clinicalmanifestations such as abdominal pain, hematochezia, shin purpura,angioneurotic edema, joint pain, and the change of microalbuminurine,urine RBC count before and after treatment in group A and B. Collected3ml venous blood from the cases in group C; before and afterconventional treatment in group A; before and after the first, the second,the third time of hemoperfusiom treatment in group C. Centrifuged all theblood specimens and extracted the upper clear liquid and detect theirserum insulin-like growth factor-1, interleukin-17values with enzyme-linked immunosorbent assay. The differences of aboveparameters and clinical symptoms were compared between in groups.Results: After treatment, the clinical manifestations such as abdominalpain, hematochezia, shin purpura, angioneurotic edema, joints pain wererelieved. And the remission was much more obvious in group B than thatin group A, and the hospitalization time was much shorter in group Bthan in group A. But the changes of microalbuminurine, the urine RBCcount had no statistic significance before and after treatment in group Aand B. Before treatment, the serum insulin-like growth factor-1,interleukin-17levels were significantly higher in the group A and B thanin group C, while no statistics significance between group A and B. Aftertreatment, the above cytokines are decreased with statisticallysignificance (P<0.01) in the group A and B. Compared with the group A,the above parameters were decreased much more apparently after thethird perfusion in the group B (P<0.01). But after treatment, theparameters in the group A and B were still higher than that in group C. Inthe group B, the cytokines decreased obviously after three timesperfusion, but the changes had no statistics significance (P>0.05) after thefirst perfusion. The serum insulin-like growth factor-1, interleukin-17levels were much higher in patients with henoch-schonlein purpuriticnephritis than without it, and it had statistically significance (P<0.01).Through the correlation analysis, it has positive correlation between insulin-like growth factor-1and interleukin-17(P<0.05); microal-buminurine had positive correlation with insulin-like growth factor-1andinterleukin-17(P<0.05). Conclusions:1.The serum insulin-like growthfactor-1and interleukin-17increased in patients with severe henoch-schonlein purpura and the cytokines might play an important roleinvasculitis in henoch-schonlein purpura.2. Hemoperfusion andtraditional treatment had better effect on cases with severe henoch-schonlein purpura than traditional treatment itself.3. Hemoperfusion andtraditional treatment could eliminate serum insulin-like growth factor-1,interleukin-17and reduce the damage of vasculitis more effectively thanthe traditional treatment itself.4. The serum insulin-like growth factor-1and interleukin-17levels were higher in patients with henoch-schonleinpurpuritic nephritis than patients without it.5. Hemoperfusion andtraditional treatment could eliminate the above serum inflammatorymediators more effectively than the traditional treatment itself, but bothmethods had no effect on patients with microalbuminurine and urine RBCcount. Whether hemoperfusion and traditional treatment could improvethe prognosis of henoch-schonlein purpuritic nephritis stills neededfurther study. |
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