摘要目的 探讨细菌溶解产物改善激素依赖型肾病综合征患儿免疫功能.方法 将2016年6月至2017年6月本院收治92例激素依赖型肾病综合征患儿随机分为观察组46例和对照组46例.对照组在常规治疗基础上加用泼尼松,观察组在对照组基础上加用细菌溶解产物.比较两组临床疗效、肾病复发次数、呼吸道感染次数及激素剂量情况,并比较治疗前后两组免疫功能变化水平.结果 观察组总缓解率明显高于对照组(91.3％比73.9％),差异具有统计学意义(x 2=4.842,P=0.028);观察组肾病复发次数、呼吸道感染次数明显低于对照组(t=8.440、9.258,P=0.000、0.000),而激素剂量比较,差异无统计学意义(t=0.430,P=0.334).治疗后,观察组IgA、IgG明显高于对照组,IgE显著低于对照组(t=11.609、4.288、2.191,P=0.000、0.000、0.016);观察组CD4+、CD4+/CD8+明显高于对照组,CD8+显著低于对照组(t=1.915、1.776、1.756,P=0.029、0.039、0.041).两组患者不良反应发生率比较,差异无统计学意义(x2=0.956,P=0.328).结论 细菌溶解产物可改善激素依赖型肾病综合征患儿疗效,提高患儿免疫功能,且不增加治疗风险,值得临床推广.

abstractsObjective To investigate whether bacterial lysis product can improve immune function in children with steroid-dependent nephrotic syndrome.Methods 92 children with steroid-dependent nephrotic syndrome treated at our hospital from June,2016 to June,2017 were selected,and were divided into an observation group and a control group,46 cases for each group.The control group were treated with prednisone.Based on the control group,the observation group were treated with bacterial lysis product.The clinical efficacy,the number of relapse of nephrotic syndrome,the frequency of respiratory infections,hormonal dose,and changes in immune function before and after the treatment of the two groups were compared.Results The total remission rate was significantly higher in the observation group than in the control group (91.3％ vs.73.9％,x 2=4.842,P =0.028).The numbers of renal relapse and respiratory tract infection were significantly lower in the observation group than in the control group (t =8.440 and 9.258,P =0.000 and 0.000),while there was no statistical difference in hormonal dose between these two groups (t =0.430,P =0.334).After the treatment,IgA and IgG were significantly higher and IgE was significantly lower in the observation group than in the control group (t =11.609,4.288,and 2.191;P =0.000,0.000,and 0.016).CD4+ and CD4+/CD8+were significantly higher and CD8+ was significantly lower in the observation group than in the control group (t =1.915,1.776,and 1.756;P =0.029,0.039,and 0.041).There was no statistical difference in the incidence of adverse reactions between the two groups (x 2=0.956,P =0.328).Conclusion Bacterial lysis product can effectively improve immune function in children with steroid-dependent nephrotic syndrome,and does not increase the treatment risk,so it is worth being clinically generalized.