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目的探讨雷公藤总苷治疗儿童紫癜性肾炎(HSPN)的临床药理疗效及对血清TNF-α和IL-8水平的影响。方法 38例HSPN患儿随机分为2组,对照组18例给予抗血小板聚集、抗组胺、低分子肝素钠、泼尼松等常规治疗,而治疗组20例在此基础上加用雷公藤总苷片治疗,每日1.5 mg.kg-1,连用4周。观察2组的临床治疗效果及皮肤紫癜、24 h尿蛋白定量、尿沉渣分析的变化,采用放射免疫法检测其治疗前后血清TNF-α和IL-8水平变化,采用SPSS 11.5进行统计学分析。结果治疗组临床总有效率高于对照组(χ2=10.526,P<0.05);两组患儿治疗后血清TNF-α和IL-8水平均下降,其中以治疗组下降更明显,差异有统计学意义(P<0.01)。结论雷公藤总苷对儿童HSPN有较好疗效,其机制可能和抑制血清TNF-α和IL-8水平有关。
Objective To investigate the clinical pharmacological effects of Tripterygium glycosides on children with Purpura nephritis (HSPN) and its effects on serum levels of TNF-α and IL-8. Methods Thirty-eight cases of HSPN were randomly divided into two groups. The control group received anti-platelet aggregation, antihistamine, low molecular weight heparin and prednisone. In the treatment group, 20 patients were treated with tripterygium wilfordii Total glycosides tablets, daily 1.5 mg.kg-1, once every 4 weeks. The clinical curative effect and the changes of skin purpura, 24 h urinary protein and urinary sediment analysis were observed. The levels of TNF-α and IL-8 in serum before and after treatment were measured by radioimmunoassay and analyzed by SPSS 11.5. Results The total clinical effective rate in the treatment group was higher than that in the control group (χ2 = 10.526, P <0.05). The levels of serum TNF-α and IL-8 in both groups decreased after treatment, especially in the treatment group Significance (P <0.01). Conclusion Tripterygium glycosides have a good effect on HSPN in children, and its mechanism may be related to the inhibition of serum TNF-α and IL-8 levels.