| Objective:To observe the changes of lymphocyte subsets before and after corticosteroid administration in children with Henoch-Sch?nlein Purpura(HSP),and to Investigate the immune disorders and pathogenesis of the disease.Method:Select the data of hospitalized children with HSP in our hospital from December 2018 to February 2020,including general information,clinical manifestations,laboratory examination results,treatment process and disease outcome.Collected separately children's blood specimens that before and after treatment with methylprednisolone,using FACSCalibur Flow Cytometer monitor children's peripheral blood NK cells,B lymphocyte and percentage of T lymphocyte subgroup,using itself for comparison,observing the changes of lymphocyte subsets before and after treatment of children with HSP and different types of children's lymphocyte subsets,immunoglobulin and complement characteristics;SPSS22.0 software was used for data analysis to investigate the immune disorders and pathogenesis of Henoch-Sch?nlein Purpura(HSP).Results:1.Participants included 80 cases of children with HSP,including 49 men(61.25%)and 31 woman(38.75%),ages ranging from 1 to 15,the median age was 6.76,the high incidence of age was 5~8(25~75 percentile),According to the initial symptoms of admission,19 cases(23.75%)were divided into the mixed type HSP group,25 cases(31.25%)were divided into the articular type HSP group,19 cases(23.75%)were divided into the abdominal type HSP group,and 17 cases(21.25%)were divided into the renal type HSP group.According to the results of routine urine test,25 cases(31.25%)were divided into the renal type group and 55 cases(68.75%)were divided into the non-renal type group.2.Comparing with before treatment,the values of CD3~+T,CD8~+T,NK cells and B cells in children with HSP decreased that the differences had statistically significant(P<0.05),The values of CD4~+T and CD4~+/CD8~+increased that the differences had statistically significant(P<0.05).3.According to the initial symptoms of admission or the results of routine urine test,the changes before and after treatment had no statistically significant in the values of CD3~+T,CD8~+T,NK cells,B cells,CD4~+T and CD4~+/CD8~+between the two groups(P>0.05).4.Multiple regression analysis showed that NK cells had a significant positive impact on B cells(B=0.438,P<0.05).5.According to the urine test results,the mean serum IgG and serum IgA of the kidney-type group were higher than those of the non-kidney-type group that the differences had statistically significant(P<0.05),while there were no significant difference in IgM,complement C3 and complement C4 between the two groups(P>0.05).6.According to age stage,there were no statistically significant difference in values of IgG and IgA at each age children with HSP who was in the acute stage(P>0.05),while there were statistically significant differences in IgM,complement C3 and complement C4(P<0.05).Conclusions:1.The values of CD4~+T and CD4~+/CD8~+in children with HSP in remission stage were significantly higher than those in acute stage.The values in the remission stage of CD3~+T,CD8~+T,NK cells and B cells were all decreased.Lymphocyte subset dysfunction improves after corticosteroid treatment.2.There is a positive impact between NK cells and B cells.Children with HSP have both humoral and cellular immune disorders,and the two also impact each other.3.There had no significant that Lymphocyte subsets were used to identify the presence or absence of early kidney damage in children with HSP.4.The serum IgG and IgA were significantly increased in children who had renal damage with HSP.The increased serum IgG and IgA values may be a risk factor for HSP children to develop HSPN.The serum IgG and IgA can be used to a reference to identify the presence of early kidney damage in children with HSP. |
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