原发性肾病综合征患儿免疫状态及槐杞黄颗粒对其的调节作用
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摘要
目的
观察槐杞黄颗粒辅助治疗肾病综合征患儿对淋巴细胞亚群、免疫球蛋白及感染次数的影响。
方法
选择2008年1月1日—2008年12月31日小儿肾脏内科住院的原发性肾病综合征(PNS)患儿101例,其中男60例,女41例,年龄1-14岁,随机分为两组,激素联合应用槐杞黄颗粒(A组)62例,单独服用激素(B组)39例,正常对照(C组)为本院正常体检儿童22例,其中男13例,女9例。分别于治疗前(A0、B0)和治疗3月(A3、B3)、6月(A6、B6)检测患儿的淋巴细胞亚群、免疫球蛋白及记录感染次数、肾病复发次数和服药副作用(每例观察6月)。
结果
1、肾病治疗前AO组(62例)、B0组(39例)CD8+均明显高于C组(P<0.05),CD4+明显低于C组(22例)(P<0.05),CD4+／CD8+比值明显降低甚至倒置(P<0.05),NK细胞明显低于C组(P<0.01),IgA与IgG明显低于C组(P<0.05,P<0.01)。2、治疗3个月,总T细胞：A3组(39例)高于A0、B3和C组(P<0.05),B3组变化不明显；CD8+：A3组与A0、B3组无异,仍高于C组(P<0.05),B3组与B0组无异,更高于C组(P<0.01)；CD4+：A3组与A0、C组无异,高于B3组(P<0.01),B3组与B0组无异,仍低于C组(P<0.01)；CD4+／CD8+:A3组与AO组无异,高于B3组(P<0.05),低于C组(P<0.05),B3组与B0组无异,仍低于C组(P<0.01)；NK细胞：A3组高于A0组(P<0.01),高于B3组(P<0.05),与C组无异,B3组高于B0组(P<0.01),与C组无异；总B细胞：A3组低于A0、B3和C组(P<0.01),B3组低于B0组(P<0.05),与C组无异；IgA:A3组与A0、B3组无异,低于C组(P<0.05),B3组与B0组无异,低于C组(P<0.05)；IgG：A3组高于A0组(P<0.01),与B3组无异,仍低于C组(P<0.01),B3组高于B0组(P<0.01),仍低于C组(P<0.01)；IgM:A3组低于A0组(P<0.01),与B3、C组无异常,B3组低于BO组(P<0.01),与组无异。3、治疗6个月,总T细胞：A6组(23例)与A3、B6和C组无异,B3组(9例)变化不明显；CD8+：A6组与A3、B6、C组无异,B6组与B3、C组无异；CD4+：A6组与A3、B6、C组无异,B6组与B3、C组无异；CD4+／CD8+:A6组与A3、B6组无异,低于C组(P<0.01),B6组与B3组无异,仍低于C组(P<0.05)；NK细胞：A6组与A3、B6和C组无异,B6与B3、C组无异；总B细胞：A6组低于C组(P<0.05),与B3、C组无异,B6与B3、C组无异；IgA:A6组与A3、B6和C组无异,B6组与B3、C组无异；IgG:A6组与A3、B6组无异,低于C组(P<0.05),B6组与B3、C组无异；IgM:A6组与A3、B6和C组无异,B6组与B3、C组无异。4、感染次数,A组共发生上呼吸道感染6人次,肺炎2人次,占12.90%,肾病复发4人次,占6.45%。B组发生上呼吸道感染8人次,肺炎3人次,泌尿系感染2人次,占33.33%,肾病复发6人次,占15.38%。5、副作用：一名患儿服槐杞黄颗粒后出现较严重腹泻(排除感染性腹泻)。
结论
肾病综合征患儿治疗前细胞、体液免疫功能降低、紊乱；槐杞黄颗粒辅助治疗PNS过程中,提高NK杀伤细胞和T辅助淋巴细胞活性,减少感染并具有减少肾病复发的趋势。槐杞黄颗粒副作用轻微,可作为PNS治疗的辅助药物。
Objective
To observe the effect of Huaiqiuang paiticles on lymphocyte subpopulation, immunoglobulins and the infection of children with primary nephritic syndrome.
Method
Totally 101 patients(60 males and 41 females,1-14 years old) first diagnosed with PNS were randomly divided into group A (62 cases) and group B (39 cases). Group A was treated with prednisone and Huaiqihuang particles, while Group B was treated with prednisone only. Observe the level of lymphocyte subpopulation and immunoglobulins before the treatment(A0,B0),3months(A3,B3) and 6months(A6,B6) after treatment. Record the infection and relapse patients within 6 months. Group C was control group (22 healthy children,13 males and 9 females).
Result
1 The CD8+T lymphocytes in group AO and BO were significantly higher than that of group C(P<0.05),while the CD4+T lymphocytes were significantly fewer (P<0.05),the proportion of CD4+to CD8+was significantly decreased, even inversion (P＜0.05).The level of NK cells in group AO and BO were significantly fewer than that of group C (P＜0.01). The IgA and IgG in group AO and BO were significantly fewer than that of group C (P<0.05, P<0.01).
2 3 month after treatment, the total T cells in group A3 was significantly higher than that of group A0,B3 and group C (P<0.05); the CD8+T cells in groupA3, AO and B3 were higher than group C(P<0.05), but there were no difference among groupA3, AO and B3; there were no difference of the CD8+T cells between group B3 and B0, which were both higher than that of group C(P<0.01); the CD4+T cells in groupA3, AO and group C were higher than that of group B3(P<0.01), but there were no difference among groupA3, AO and C; there were no difference of the CD4+T cells between group B3 and B0, which were both lower than that of group C(P<0.01);the CD4+/CD8+of group A3 and AO were higher than that of group B3(P<0.05),but lower than that of group C(P<0.05), there were no difference between group A3 and A0; the CD4+/CD8+of group B3 and BO were lower than that of group C(P<0.01), there were no difference between group B3 and B0(P<0.05); NK cells in group A3 was higher than that of group AO(P＜0.01) and group B3(P<0.05),but had no difference with groupC; NK cells in group B3 was higher than that of group B0(P<0.01),but had no difference with groupC; total B cells in group A3 was lower than that of group A0,B3 and C(P<0.01), total B cells in group B3 was lower than that of group B0, but had no difference with groupC; IgA in group A3, AO and B3 were lower than that of group C(P<0.05),but there were no difference among group A3, AO and B3; IgA in group B3 and BO were lower than that of group C, but there was no difference between these two groups; IgG in group A3 was higher than that of group A0(P<0.01),lower than that of group C(P<0.01),but there was no difference with group B3; IgG in group B3 were higher than that of group B0(P<0.01), but still lower than groupC(P＜0.01); IgM in group A3 was lower than that of group A0(P<0.01), but there were no difference with group B3 and C; IgM in group B3 were lower than that of group BO(P＜0.01);
3 6month after treatment, there were no differences of the total T cells among the group A6, A3, B6 and C; there were no differences of CD8+T cells and CD4+T cells among the group A6, A3, B6 and C; there were no differences of CD8+T cells and CD4+T cells among the group B6, B3 and C; the CD4+/CD8+in group A6 A3 and B6 were lower than that of group C(P<0.01), there were no differences among group A6 A3 and B6; the CD4+/CD8+in group B6 and B3 were lower than that of group C(P<0.01), there were no differences between group B6 and B3; there were no differences of NK cells among group A6, A3,B6 and C, there were no differences of NK cells among group in group B6,B3 and C; total B cells in group A6 was lower than that of group C(P<0.05), there were no differences between group B3 and C, there were no differences of total B cells among group B6,B3 and groupC; there were no difference of IgA among group A6,A3,B3 and group C, there were no difference of IgA among group B6,B3 and group C; IgG in group A6,A3 and B6 were lower than that of group C(P<0.05), there were no differences among group B6,B3 and groupC; there were no difference of IgM among group A6,A3,B3 and group C, there were no difference of IgM among group B6,B3 and group C;
4 The infection times of group A (12.9%,upper respiratory tract infection 6 times, pneumonia 2 times) were significantly fewer than group B (33.33%, upper respiratory tract infection 8 times, pneumonia 3 times, urinary tract infection 2times), and the relapse cases of group A (4,6.45%) were fewer than group B (6,15.38%).
5 Side effect of Huaiqiuang particles, severe diarrhea(lcase).
Conclusion
The cell immunity and the body fluid immunity is decreased and disturbed before theapy; the Huaiqihuang particles can improve the ability of NK cells and T help cells, decrease the infection and relapse of nephrotic syndrome; at the same time, Huaiqihuang particles has milt side effects.
观察槐杞黄颗粒辅助治疗肾病综合征患儿对淋巴细胞亚群、免疫球蛋白及感染次数的影响。
方法
选择2008年1月1日—2008年12月31日小儿肾脏内科住院的原发性肾病综合征(PNS)患儿101例,其中男60例,女41例,年龄1-14岁,随机分为两组,激素联合应用槐杞黄颗粒(A组)62例,单独服用激素(B组)39例,正常对照(C组)为本院正常体检儿童22例,其中男13例,女9例。分别于治疗前(A0、B0)和治疗3月(A3、B3)、6月(A6、B6)检测患儿的淋巴细胞亚群、免疫球蛋白及记录感染次数、肾病复发次数和服药副作用(每例观察6月)。
结果
1、肾病治疗前AO组(62例)、B0组(39例)CD8+均明显高于C组(P<0.05),CD4+明显低于C组(22例)(P<0.05),CD4+／CD8+比值明显降低甚至倒置(P<0.05),NK细胞明显低于C组(P<0.01),IgA与IgG明显低于C组(P<0.05,P<0.01)。2、治疗3个月,总T细胞：A3组(39例)高于A0、B3和C组(P<0.05),B3组变化不明显；CD8+：A3组与A0、B3组无异,仍高于C组(P<0.05),B3组与B0组无异,更高于C组(P<0.01)；CD4+：A3组与A0、C组无异,高于B3组(P<0.01),B3组与B0组无异,仍低于C组(P<0.01)；CD4+／CD8+:A3组与AO组无异,高于B3组(P<0.05),低于C组(P<0.05),B3组与B0组无异,仍低于C组(P<0.01)；NK细胞：A3组高于A0组(P<0.01),高于B3组(P<0.05),与C组无异,B3组高于B0组(P<0.01),与C组无异；总B细胞：A3组低于A0、B3和C组(P<0.01),B3组低于B0组(P<0.05),与C组无异；IgA:A3组与A0、B3组无异,低于C组(P<0.05),B3组与B0组无异,低于C组(P<0.05)；IgG：A3组高于A0组(P<0.01),与B3组无异,仍低于C组(P<0.01),B3组高于B0组(P<0.01),仍低于C组(P<0.01)；IgM:A3组低于A0组(P<0.01),与B3、C组无异常,B3组低于BO组(P<0.01),与组无异。3、治疗6个月,总T细胞：A6组(23例)与A3、B6和C组无异,B3组(9例)变化不明显；CD8+：A6组与A3、B6、C组无异,B6组与B3、C组无异；CD4+：A6组与A3、B6、C组无异,B6组与B3、C组无异；CD4+／CD8+:A6组与A3、B6组无异,低于C组(P<0.01),B6组与B3组无异,仍低于C组(P<0.05)；NK细胞：A6组与A3、B6和C组无异,B6与B3、C组无异；总B细胞：A6组低于C组(P<0.05),与B3、C组无异,B6与B3、C组无异；IgA:A6组与A3、B6和C组无异,B6组与B3、C组无异；IgG:A6组与A3、B6组无异,低于C组(P<0.05),B6组与B3、C组无异；IgM:A6组与A3、B6和C组无异,B6组与B3、C组无异。4、感染次数,A组共发生上呼吸道感染6人次,肺炎2人次,占12.90%,肾病复发4人次,占6.45%。B组发生上呼吸道感染8人次,肺炎3人次,泌尿系感染2人次,占33.33%,肾病复发6人次,占15.38%。5、副作用：一名患儿服槐杞黄颗粒后出现较严重腹泻(排除感染性腹泻)。
结论
肾病综合征患儿治疗前细胞、体液免疫功能降低、紊乱；槐杞黄颗粒辅助治疗PNS过程中,提高NK杀伤细胞和T辅助淋巴细胞活性,减少感染并具有减少肾病复发的趋势。槐杞黄颗粒副作用轻微,可作为PNS治疗的辅助药物。
Objective
To observe the effect of Huaiqiuang paiticles on lymphocyte subpopulation, immunoglobulins and the infection of children with primary nephritic syndrome.
Method
Totally 101 patients(60 males and 41 females,1-14 years old) first diagnosed with PNS were randomly divided into group A (62 cases) and group B (39 cases). Group A was treated with prednisone and Huaiqihuang particles, while Group B was treated with prednisone only. Observe the level of lymphocyte subpopulation and immunoglobulins before the treatment(A0,B0),3months(A3,B3) and 6months(A6,B6) after treatment. Record the infection and relapse patients within 6 months. Group C was control group (22 healthy children,13 males and 9 females).
Result
1 The CD8+T lymphocytes in group AO and BO were significantly higher than that of group C(P<0.05),while the CD4+T lymphocytes were significantly fewer (P<0.05),the proportion of CD4+to CD8+was significantly decreased, even inversion (P＜0.05).The level of NK cells in group AO and BO were significantly fewer than that of group C (P＜0.01). The IgA and IgG in group AO and BO were significantly fewer than that of group C (P<0.05, P<0.01).
2 3 month after treatment, the total T cells in group A3 was significantly higher than that of group A0,B3 and group C (P<0.05); the CD8+T cells in groupA3, AO and B3 were higher than group C(P<0.05), but there were no difference among groupA3, AO and B3; there were no difference of the CD8+T cells between group B3 and B0, which were both higher than that of group C(P<0.01); the CD4+T cells in groupA3, AO and group C were higher than that of group B3(P<0.01), but there were no difference among groupA3, AO and C; there were no difference of the CD4+T cells between group B3 and B0, which were both lower than that of group C(P<0.01);the CD4+/CD8+of group A3 and AO were higher than that of group B3(P<0.05),but lower than that of group C(P<0.05), there were no difference between group A3 and A0; the CD4+/CD8+of group B3 and BO were lower than that of group C(P<0.01), there were no difference between group B3 and B0(P<0.05); NK cells in group A3 was higher than that of group AO(P＜0.01) and group B3(P<0.05),but had no difference with groupC; NK cells in group B3 was higher than that of group B0(P<0.01),but had no difference with groupC; total B cells in group A3 was lower than that of group A0,B3 and C(P<0.01), total B cells in group B3 was lower than that of group B0, but had no difference with groupC; IgA in group A3, AO and B3 were lower than that of group C(P<0.05),but there were no difference among group A3, AO and B3; IgA in group B3 and BO were lower than that of group C, but there was no difference between these two groups; IgG in group A3 was higher than that of group A0(P<0.01),lower than that of group C(P<0.01),but there was no difference with group B3; IgG in group B3 were higher than that of group B0(P<0.01), but still lower than groupC(P＜0.01); IgM in group A3 was lower than that of group A0(P<0.01), but there were no difference with group B3 and C; IgM in group B3 were lower than that of group BO(P＜0.01);
3 6month after treatment, there were no differences of the total T cells among the group A6, A3, B6 and C; there were no differences of CD8+T cells and CD4+T cells among the group A6, A3, B6 and C; there were no differences of CD8+T cells and CD4+T cells among the group B6, B3 and C; the CD4+/CD8+in group A6 A3 and B6 were lower than that of group C(P<0.01), there were no differences among group A6 A3 and B6; the CD4+/CD8+in group B6 and B3 were lower than that of group C(P<0.01), there were no differences between group B6 and B3; there were no differences of NK cells among group A6, A3,B6 and C, there were no differences of NK cells among group in group B6,B3 and C; total B cells in group A6 was lower than that of group C(P<0.05), there were no differences between group B3 and C, there were no differences of total B cells among group B6,B3 and groupC; there were no difference of IgA among group A6,A3,B3 and group C, there were no difference of IgA among group B6,B3 and group C; IgG in group A6,A3 and B6 were lower than that of group C(P<0.05), there were no differences among group B6,B3 and groupC; there were no difference of IgM among group A6,A3,B3 and group C, there were no difference of IgM among group B6,B3 and group C;
4 The infection times of group A (12.9%,upper respiratory tract infection 6 times, pneumonia 2 times) were significantly fewer than group B (33.33%, upper respiratory tract infection 8 times, pneumonia 3 times, urinary tract infection 2times), and the relapse cases of group A (4,6.45%) were fewer than group B (6,15.38%).
5 Side effect of Huaiqiuang particles, severe diarrhea(lcase).
Conclusion
The cell immunity and the body fluid immunity is decreased and disturbed before theapy; the Huaiqihuang particles can improve the ability of NK cells and T help cells, decrease the infection and relapse of nephrotic syndrome; at the same time, Huaiqihuang particles has milt side effects.
引文
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21 Lama G, Luongo I, Tirino G, et al. T-lymphocyte populations and cytokines in children nephrotic syndrome. Am J Kidney Dis.2002; 5:958-965.
22 张亚莉,谭峰,冯学亮.原发性肾病综合征与免疫球蛋白的关系研究[J].中国综合临床.2005；21(5)：416-418.
23 杜开先,罗予,张艳.儿童单纯性肾病综合征血清IgG、 IgA、 IgM、补体C3测定及与血浆清蛋白和尿蛋白关系[J].临床检验杂志.2008；26(4)：308-308.
24 曹勇杰.小儿原发性肾病综合征并发感染临床分析[J].临床和实验医学杂志.2009；8(9)：55-56.
1 Dominik W,Kathrin H.CIM+cD25+regulatory T cells Inhibit experimentalanti-glomerular basement membrane glomerulonephrifs inmice[J].Am Soc Nephrol,2005;16:1360.
2 Mosmann TR,Cherwinsk H,Bond MW,et al.Two types of murine helper T cell clones. [Definition according to profiles of lymphokine activiues and secreted proteins] [J]. J Immunol.1986;136:2348.
3 Abbas AK,Kenneth M,Sher A. Fuctional diversity of helper T lymphocyetes [J]. Nature. 1996;381:387.
4 Hulton SA,Shah V,Byrne MR, et al.Lymphocyte subpoulations,inter Jeukn-2 and interleukin-2 receptor expression in childhood nephritic syndrome [J].Pediatr Nephrol.1994;8:135.
5 Rerniree F,Fowell DJ,Puklavec M,et al.Glucocorticoids promote a Th2 crtokine response by CD4+T cells in vivo [J]. J Immunol.1996;156:2406.
6 Rocragnani S.The Th1/Th2 paradigm [J].Immunol Today.1997;18:263.
7田达志.槐杞黄颗粒治疗小儿反复呼吸道感染80例临床观察[J].实用医技杂志.2004；11(17)：2346-2347.
8姚磊,向阳,康铃,等.肾病综合征患者血清1g和补体c3的测定及临床意义探讨[J].重庆医学.2006；35(18)：1656—1657.
9张亚莉,谭峰,冯学亮.原发性肾病综合征与免疫球蛋白的关系研究[J].中国综合临床.2005；21(5)：416-418.
10李兰维,张润秋,苏如松.参芪降糖颗粒对肾病综合征T淋巴细胞亚群的影响[J].中华今日医学杂志.2004；4(5)：20-21.
11毕玉娜,朱静孙,建新,等.原发性肾病综合征患儿淋巴细胞亚群研究[J].苏州医学.2007；30(2)：321-322.
12刘建华,何威逊.儿童原发性肾病综合征与Th1／Th2细胞失衡[J].中华肾脏病杂志.2000；18(20)：100.
13奚华明,朱辟疆.黄芪注射液对肾病综合征免疫功能的影响[J].浙江省中西医结合杂志.2003；13(12)：746-748.
14耿晓敛,兰志宏.黄芪对肾病综合征患者血浆蛋白及尿蛋白的影响[J].现代中西医结合杂志.2001；10(23)：2264-2265.
15于为民,刘高毅.黄芪注射液治疗复发性肾病综合征疗效观察[J].山西中医学院学报.2005；6(3)：41-42.
16余凌,李惊子,洪健美,等.黄芪当归合剂降低肾病综合征大鼠血脂机制的探讨[J].中华肾脏病杂志.1999；15(6)：337-339.
17李宁军,李惊子,洪海燕,等.黄芪当归合剂对肾综鼠脂蛋白脂酶与卵磷脂胆固醇酰基转移酶的影响[J].中国中西医结合杂志.1999；19(8)：484.
18彭卫华,曲强.黄芪治疗肾脏病的现代药理研究[J].中国中西医结合肾病杂志.2001；2(10)：614-616.
19马骥,陈靖,顾勇,等.肾病综合征大鼠精氨酸血.管加压素和V2受体与水孔蛋白
-2的研究及黄芪的治疗作用[J].肾脏病与透析肾移植杂志.1999；8(4)：315.
20蒋晏.黄芪注射液在原发性肾病综合征中应用的疗效观察.四川医学.2008；29(2)：164-165.
21徐培菊,李强,杨锡强,等.黄芪对肾病综合征患儿血清免疫球蛋白G及血清蛋白的影响[J].实用儿科临床杂志.2000；15(5)：278-279.
22韦先进,朱辟疆.黄芪对难治性肾病综合征凝血纤溶的影响[J].中国中西医结合肾病杂志.2002；3(12)：709-710.
23高岩,林飞进,钟桴,等.肾病综合征患儿血清IL—8的变化及黄芪和激素对其影响[J].中国中西医结合肾病杂志.2002；3(5)：28.
24林飞进,黄金城,崔敏娴.黄芪注射液对肾病综合征患儿血生化和免疫球蛋白的影响[J].中国中西医结合肾病杂志.2008；9(1)：72-73.
25张罗修.免疫药理学[M].上海医科大学出版社.1990；133-134.
26 Szeto C C,Gillespie K M,Mathieson P W.Levamisol induces interleukin—18 and shift typel/type2 cytokine balance[J].Immunol.2000;100:217-224.
27卢宏柱.左旋咪唑对肾病综合征患儿免疫功能的影响[J].长江大学学报(自然版)2005；2(9)：236-238.
28洪建东,傅清流,苏志强,等.丙种球蛋白治疗儿童原发性肾病综合征的疗效及免疫功能变化[J].中华肾脏病杂志.2007；23(12)：772.
29刘光陵,夏正坤,高远赋,等.口服转移因子对原发性肾病综合征患儿T细胞亚群的影响[J].江苏医药.1998；24(9)：628-630.
30李红梅,李利群.转移因子口服液佐治小儿单纯性肾病综合征临床研究[J].西南国防医药.2007；17(4)：423-424.
31 Yang-Yen HF,Chambard JC,Sun YL, et al.Transcriptional interference between c-jun and the glucocorsteroid receptor:mutual inhibition of DNA binding due to direct protein-protein interaction,Cell,1990;62:1205.
32 Austin II HA.Membranous nephropathy.Ann Intern Med.1992;116:672.
33张粒,张成武,舒荣华.转移因子对单核细胞的趋化活性及其对单核细胞趋化反应的影响[J].中国实验临床免疫学杂志.1994；6(2)：7-10.
34刘光陵,夏正坤,高远赋,等.转移因子对小儿微小病变型肾病综合征的疗效观察.肾脏病与透析肾移植杂志[J].1999；8(4)：348-349.
2 杨霁云,陈述枚,姚勇,等.小儿肾脏疾病的临床分类、诊断及治疗[J].中华儿科杂志,2001；39(12)：746-749.
3 韩志英.槐杞黄颗粒治疗小儿反复呼吸道感染50例[J].中国中西医结合杂志.2004；24(6)：563-564.
4李新民,马融,李少川,等.中药肾病合剂减少儿童单纯型肾病综合征复发的临床研究[J].中国中西医结合杂志.2002；22(9)：650-653.
5 田达志.槐杞黄颗粒治疗小儿反复呼吸道感染80例临床观察[J].实用医技杂志.2004；11(17)：2346-2347.
6黄琼.还尔金-槐杞黄颗粒治疗脑瘫患儿反复呼吸道感染62例疗效观察[J].河南中医学院学报2004；]9(4)：65-65.
7刘振翔,杜华.原发性肾病综合征患儿外周血淋巴细胞亚群的观察[J].广西医科大学学报.2003；25(10)：1856.
8蓝程,杨锡强,李成荣,等.CD46+T淋巴细胞在激素敏感型肾病综合征发病中的作用研究[J].中华儿科杂志.2001；39(4)：240-243.
9 Dominik W, Kathrin H. CD4+CD25+regulatory T cells Inhibit experimentalanti-glomerular basement membrane glomerulonephrifs inmice. J Am Soc Nephrol.2005; 16(5):1360-70.
10陆彪,梁丽俊,邓璐璐,等.原发性肾病综合征患儿T细胞亚群的变化及意义[J].宁夏医学杂志.2008；30(12)：1113-1114.
11 Mosmann TR, Cherwinsk H, Bond MW, et al. Two types of murine helper T cell clone I. Definition according to profiles of lymphokine activiues and secreted proteins. The Journal of Immunology.2005; 175(1):2348.
12黄建亭.单纯性肾病综合征患儿T淋巴细胞亚群及体液免疫变化[J].实用儿科临床杂志.2005：20(1)：53-54.
13 Shalhoub RJ. Pathogenesis of lipid nephrosis a disorder of T cell function. Lancet.1974; 2 (7880)：556-560.
14 刘建华,何威逊.糖皮质激素对原发性肾病综合征患儿T辅助细胞平衡的影响[J].中华微生物学和免疫学杂志.2002；22(1)：71-75.
15 梁丽俊,周超,周娅.儿童原发性肾病综合征细胞免疫与激素疗效的关系[J].宁夏医学杂志.2010；32(01)：41-42.
16 Abbas AK, Kenneth M.Sher A. Fuctional diversity of helper T lymphocyetes. Nature.1996; 381(6581):387-93.
17 Stachowski J, Barth C, Michalkiewicz J. Th1/Th2 balance and CD45-positive T cell subsets in primary nephritic syndrome [J]. Pediatric Nephrology.2000; 14(8/9):779-785.
18 王国兵,杨军,李成荣,等.泼尼松治疗原发性肾病综合征对患儿CD4～+CD25～+调节性T细胞的影响分析.中国实用儿科杂志[J].2009；34(5)：319-321.
19 于力,卓美瑛,杨小苏,等.肾病综合征患儿细胞免疫和细胞因子的变化及其意义[J].中国实用儿科杂志.2001；16(8)：483-485.
20 张琳琳,赵学兰.肾病综合征细胞免疫研究进展[J].医学综述.2007；13(18)：1414-1416.
21 Lama G, Luongo I, Tirino G, et al. T-lymphocyte populations and cytokines in children nephrotic syndrome. Am J Kidney Dis.2002; 5:958-965.
22 张亚莉,谭峰,冯学亮.原发性肾病综合征与免疫球蛋白的关系研究[J].中国综合临床.2005；21(5)：416-418.
23 杜开先,罗予,张艳.儿童单纯性肾病综合征血清IgG、 IgA、 IgM、补体C3测定及与血浆清蛋白和尿蛋白关系[J].临床检验杂志.2008；26(4)：308-308.
24 曹勇杰.小儿原发性肾病综合征并发感染临床分析[J].临床和实验医学杂志.2009；8(9)：55-56.
1 Dominik W,Kathrin H.CIM+cD25+regulatory T cells Inhibit experimentalanti-glomerular basement membrane glomerulonephrifs inmice[J].Am Soc Nephrol,2005;16:1360.
2 Mosmann TR,Cherwinsk H,Bond MW,et al.Two types of murine helper T cell clones. [Definition according to profiles of lymphokine activiues and secreted proteins] [J]. J Immunol.1986;136:2348.
3 Abbas AK,Kenneth M,Sher A. Fuctional diversity of helper T lymphocyetes [J]. Nature. 1996;381:387.
4 Hulton SA,Shah V,Byrne MR, et al.Lymphocyte subpoulations,inter Jeukn-2 and interleukin-2 receptor expression in childhood nephritic syndrome [J].Pediatr Nephrol.1994;8:135.
5 Rerniree F,Fowell DJ,Puklavec M,et al.Glucocorticoids promote a Th2 crtokine response by CD4+T cells in vivo [J]. J Immunol.1996;156:2406.
6 Rocragnani S.The Th1/Th2 paradigm [J].Immunol Today.1997;18:263.
7田达志.槐杞黄颗粒治疗小儿反复呼吸道感染80例临床观察[J].实用医技杂志.2004；11(17)：2346-2347.
8姚磊,向阳,康铃,等.肾病综合征患者血清1g和补体c3的测定及临床意义探讨[J].重庆医学.2006；35(18)：1656—1657.
9张亚莉,谭峰,冯学亮.原发性肾病综合征与免疫球蛋白的关系研究[J].中国综合临床.2005；21(5)：416-418.
10李兰维,张润秋,苏如松.参芪降糖颗粒对肾病综合征T淋巴细胞亚群的影响[J].中华今日医学杂志.2004；4(5)：20-21.
11毕玉娜,朱静孙,建新,等.原发性肾病综合征患儿淋巴细胞亚群研究[J].苏州医学.2007；30(2)：321-322.
12刘建华,何威逊.儿童原发性肾病综合征与Th1／Th2细胞失衡[J].中华肾脏病杂志.2000；18(20)：100.
13奚华明,朱辟疆.黄芪注射液对肾病综合征免疫功能的影响[J].浙江省中西医结合杂志.2003；13(12)：746-748.
14耿晓敛,兰志宏.黄芪对肾病综合征患者血浆蛋白及尿蛋白的影响[J].现代中西医结合杂志.2001；10(23)：2264-2265.
15于为民,刘高毅.黄芪注射液治疗复发性肾病综合征疗效观察[J].山西中医学院学报.2005；6(3)：41-42.
16余凌,李惊子,洪健美,等.黄芪当归合剂降低肾病综合征大鼠血脂机制的探讨[J].中华肾脏病杂志.1999；15(6)：337-339.
17李宁军,李惊子,洪海燕,等.黄芪当归合剂对肾综鼠脂蛋白脂酶与卵磷脂胆固醇酰基转移酶的影响[J].中国中西医结合杂志.1999；19(8)：484.
18彭卫华,曲强.黄芪治疗肾脏病的现代药理研究[J].中国中西医结合肾病杂志.2001；2(10)：614-616.
19马骥,陈靖,顾勇,等.肾病综合征大鼠精氨酸血.管加压素和V2受体与水孔蛋白
-2的研究及黄芪的治疗作用[J].肾脏病与透析肾移植杂志.1999；8(4)：315.
20蒋晏.黄芪注射液在原发性肾病综合征中应用的疗效观察.四川医学.2008；29(2)：164-165.
21徐培菊,李强,杨锡强,等.黄芪对肾病综合征患儿血清免疫球蛋白G及血清蛋白的影响[J].实用儿科临床杂志.2000；15(5)：278-279.
22韦先进,朱辟疆.黄芪对难治性肾病综合征凝血纤溶的影响[J].中国中西医结合肾病杂志.2002；3(12)：709-710.
23高岩,林飞进,钟桴,等.肾病综合征患儿血清IL—8的变化及黄芪和激素对其影响[J].中国中西医结合肾病杂志.2002；3(5)：28.
24林飞进,黄金城,崔敏娴.黄芪注射液对肾病综合征患儿血生化和免疫球蛋白的影响[J].中国中西医结合肾病杂志.2008；9(1)：72-73.
25张罗修.免疫药理学[M].上海医科大学出版社.1990；133-134.
26 Szeto C C,Gillespie K M,Mathieson P W.Levamisol induces interleukin—18 and shift typel/type2 cytokine balance[J].Immunol.2000;100:217-224.
27卢宏柱.左旋咪唑对肾病综合征患儿免疫功能的影响[J].长江大学学报(自然版)2005；2(9)：236-238.
28洪建东,傅清流,苏志强,等.丙种球蛋白治疗儿童原发性肾病综合征的疗效及免疫功能变化[J].中华肾脏病杂志.2007；23(12)：772.
29刘光陵,夏正坤,高远赋,等.口服转移因子对原发性肾病综合征患儿T细胞亚群的影响[J].江苏医药.1998；24(9)：628-630.
30李红梅,李利群.转移因子口服液佐治小儿单纯性肾病综合征临床研究[J].西南国防医药.2007；17(4)：423-424.
31 Yang-Yen HF,Chambard JC,Sun YL, et al.Transcriptional interference between c-jun and the glucocorsteroid receptor:mutual inhibition of DNA binding due to direct protein-protein interaction,Cell,1990;62:1205.
32 Austin II HA.Membranous nephropathy.Ann Intern Med.1992;116:672.
33张粒,张成武,舒荣华.转移因子对单核细胞的趋化活性及其对单核细胞趋化反应的影响[J].中国实验临床免疫学杂志.1994；6(2)：7-10.
34刘光陵,夏正坤,高远赋,等.转移因子对小儿微小病变型肾病综合征的疗效观察.肾脏病与透析肾移植杂志[J].1999；8(4)：348-349.
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