摘要
目的分析血硒浓度与过敏性紫癜(HSP)患儿白介素2(IL-2)及同型半胱氨酸(HCY)的关系,为临床诊治提供新的理论依据。方法选择2017年12月—2018年8月在本科住院明确诊断为过敏性紫癜患儿30例作为病例组,另选同期门诊健康体检儿童29名作为对照组,均统计性别、年龄等资料。两组均检测血清硒、IL-2、HCY、中性粒细胞计数(NEU)、中性粒细胞百分比(NEU%)、C反应蛋白(CRP)、肾功能等指标,并进行统计学分析。结果过敏性紫癜组血清硒浓度较对照组明显降低,IL-2、HCY、NEU、NEU%、CRP均较对照组升高,差异有统计学意义(P<0.05)。紫癜组中,血清硒与IL-2、HCY均呈负相关,相关系数分别为-0.365,-0.477,差异具有统计学意义(P<0.05)。对照组中无相关关系。结论过敏性紫癜的发病机制中有IL-2和HCY的参与,硒可拮抗上述细胞因子的作用,适当补充硒的摄入有助于过敏性紫癜的治疗。
Objective To analyse the relationship between serum selenium concentration and interleukin-2( IL-2),homocysteine( HCY) in children with Henoch-Schonlein purpura( HSP),providing a new theoretical basis for clinical diagnosis and treatment. Methods Thirty children with Henoch-Schonlein purpura diagnosed in our department from December 2017 to August 2018 were selected as case group,and 29 children received health examination in outpatient department were selected as control group during the same period. Age and sex were counted in two groups. Concentrations of serum selenium,IL-2,HCY,neutrophil count( NEU),percentage of neutrophils( NEU%),C-reactive protein( CRP),and renal function were measured. The results were analyzed statistically. Results The serum selenium concentration in HSP group was lower than that in control group,however,the concentration of IL-2,HCY,NEU,NEU%,CRP were higher than that in control group( P< 0. 05),the differences were statistically significant. In HSP group,serum selenium was negatively correlated with IL-2 and HCY,the correlation coefficients were -0.365 and -0.477 respectively( P<0.05). No correlation was found in the control group. Conclusions IL-2 and HCY are involved in the pathogenesis of Henoch-Schonlein purpura.Selenium could antagonize the above cytokines. Adequate supplementation of selenium is helpful to the treatment of Henoch-Schonlein purpura.
引文
[1]《中华儿科杂志》编辑委员会.儿童过敏性紫癜循证诊治建议[M].中华儿科杂志,2013,51(7):502-507.
[2]Change H,Zhang YQ,Lin Y,et al.Correlation of TLR2 and TLR4expressions in peripheral blood mononuclear cells to Th1-and Th2-type immune responses in children with henoch-sch9nlein purpura[J].Int J Clin Exp Med,2015,8(8):13532-13539.
[3]Shin JI,Lee JS.High factor VIII or homocysteine levels and thrombosis in Henoch-Schonlein purpura[J].Rheumatol Int,2009,29(10):1251-1252.
[4]Li YY,Li CR,Wang GB,et al.Inbvestigation of the change in CD4(+)T cell subset in children with Henoch-Schonlein purpura[J].Rheumatol Int,2012,32(12):3785-3792.
[5]Reichert P,Reinhardt RL,IngμLli E,et al.Cutting edge:in vivo identification of TCR redistribution and polarized IL-2 production by naive CD4 T cells[J].J Immunol,2001,166(7):4278-4281.
[6]Wu JJ,Zhu YT,Hu YM.Mechanism of feedback regulation of neutrophil inflammation in Henoch-Sch9 nlein purpura[J].Eur Rev Med Pharmacol Sci,2016,20:4277-4285.
[7]Li Y,Sui X,Zhu H,et al.Histopathological and immunological changes during the acute and recovery phase in HenochSchonlein purpura rabbit model[J].Arch Dermatol Res,2017,309(1):21-30.
[8]Zha ng ZM,Zhao LY,Zhou YF,et al.Taurine ameliorated homocysteine-induced H9C2 cardiomyocyte apoptosis by modulating endoplasmic reticulum stress[J].Apoptosis,2017,22(5):647-661.
[9]Bai YX,Fang F,Jiang JL,et al.Extrinsic calcitonin gene-related peptide inhibits hyperoxia-induced alveolar epithelial type II cells apoptosis,oxidative stress,and reactive oxygen species(ROS)production by enhancing notch 1 and homocysteine-induced endoplasmic reticulum protein(HERP)expression[J].Med Sci Monit,2017,23:5774-5782.
[10]Kur otobi S,Kawakami N,Honda A,et al.Impaired vascular endothelium-dependent relaxation in henoch-schonlein purpura[J].Pediatr Nephrol,2004,19:43.
[11]王兆建.FIB、FDP、D-D在早期判定患儿过敏性紫癜性肾损害中的应用价值[J].青海药学院学报,2012,33(2):121-123.
[12]曹庆科.儿童过敏性紫癜患者血清同型半胱氨酸与CD62E的检测及意义[J].中国皮肤病学杂志,2013,27(9):891-892,899.
[13]Avery JC,Hoffmann PR.Selenium,selenoproteins,and immunity[J].Nutrients,2018,10(9):1203.
[14]Feske S.Calcium signalling in lymphocyte activation and disease[J].Nat Rev Immunol,2007,7(9):690-702.
[15]范于琴.硒对高同型半胱氨酸血症诱导的自发性高血压大鼠主动脉损伤的影响[D].南昌大学,2015.
[16]张吉龙.硒对同型半胱氨酸诱导的人脐静脉内皮细胞线粒体自噬损伤的抑制作用[D].南昌大学,2016.