【摘要】 目的:通过观察静脉注射免疫球蛋白(ＩＶＩＧ)对急性期川崎病(ＫＤ)患儿外周血淋巴细胞凋亡的影响,进一步探讨ＩＶＩＧ的治疗机制。方法:观察 ２６例ＫＤ患儿和 ２０例对照组外周血单核细胞(ＰＢＭＣ)经ａｎｔｉ－ＣＤ３单抗刺激培养不同时间后凋亡细胞百分率计数并进行 ＤＮＡ片断分析,观察植物血凝素(ＰＨＡ)诱导的淋巴细胞增殖反应和白细胞介素 ６(ＩＬ－６)水平。结果:ＫＤ患儿ＰＢＭＣ体外培养上清ＩＬ－６水平较对照组明显升高(Ｐ＜０．０１),ＩＶＩＧ治疗后,ＫＤ患儿ＰＢＭＣ产生ＩＬ－６水平明显降低,外周血淋巴细胞凋亡细胞百分率提高,片断ＤＡＮ出现时间提前,与治疗前比较差异显著(Ｐ＜０．０５)。同时与单用阿斯匹林组比较,临床症状改善,淋巴细胞增殖活性降低(Ｐ＜０．０１)。结论:ＩＶＩＧ治疗ＫＤ的机制可能部分归于逆转被抑制的淋巴细胞凋亡。更多还原

【Abstract】 Objective: To further study the therapeutic mechanism of intravenous immunoglobulin (IVIG) for immune - mediated disease. Methods: Peripheral blood mononeuclear cell (PBMC) obtained from 26 children with Kawasaki disease (KD) and 20 age-matched health children were stimulated by anti-CD3 monoclonal antibody, apoptotic cell percentage and DNA fragmentation were assayed in vitro; PBMC were stimulated by phytohemagglutinin (PHA) to evaluate lymphocytes proliferative response and to measure in-terleukin-6(IL-6) level in the supernatant. Results: After IVIG treatment, the decreased apoptotic cell percentage and delayed DNA fragmentation in KD patients were reversed to those of nomal controls. The clinical remissions were faster than those of patients treated with aspirin alone. Lymphoproliferative response was also down-regulated in vitro after IVIG therapy ( P < 0. 05). Conclusion: The therapeutic mechanism of IVIG for KD may be partially due to reverse the inhibited PBMC apoptosis, which provide new theory basis for treating immune-mediated disease.更多还原