The Effect And Possible Mechanism Of Hemoperfusion Treatment For Severe Henoch-Sch(o|¨)nlein Purpura

Objective:To research the change of clinical symptoms and serum free radical in patients with severe Henoch-Schonlein purpura between before and after accepted Hemopelfusion.And evaluate the curative effect of Hemopelfusion treatment for severe Henoch-Schonlein purpura and discuss the mechanism.Methods:23severe Henoch-Schonlein purpura patients in our hospital which were divided into2groups:10healthy children were divide into Hemopelfusion group,13cases were divide into traditional treatment group;11health children were divide into normal control group;Observe and record the alleviate situation of linical symptoms such as purpura,abdominal pain,joint pain,hematuria,albuminuria, and the change of urine RBC count,urine protein quantitative before and after Hemopelfusion and traditional treatment.Collected the blood specimens of before and after the first time Hemopelfusion treatment,after the second time Hemopelfusion treatment,after the third time Hemopelfusion treatment in Hemopelfusion group;Collected the blood specimens of before and after conventional therapy in traditional treatment group; collected only once blood specimen in normal control group.Then centrifuge all the blood specimens and extract the upper clear liquid.And then detect their O2-,·OH,H2O2,NO,MDA,nNOS,iNOS values with spectrophotometry,and detect the ET-1,eNOS values with ELISA method.To compare respectively the differences of each index among each group.Results:After treatment,the clinical symptoms of23severe HSP children such as rash,abdominal pain,joint pain,hematuria,albuminuria which are reliefed compared to before treatment.The urine erythrocyte count,24-hour urine protein quantitative were reduced in two groups,but the symptoms of perfusion group children relieved faster,and the clinical index decreased more obviously.The serum O2-,·OH,H2O2, NO,MDA,nNOS,eNOS,iNOS,ET-1value of23HSP children are significantly higher than the control group(P<0.01).After three times of perfusion the all indexes are decreased in perfusion group,but only after the third perfusion the indexes are decreased statistically significant(P<0.05).Compared all the indexes among after the first perfusion,after the second perfusion,after the third perfusion,only after the third perfusion contrast to after the first perfusion the indexes are reduced statistically significant(P<0.05).In the traditional treatment group, compared between before and after treatment,the indexs also are decreased(P<0.05);But compared with the perfusion group,the index are decreased more apparently in after the third perfusion, and it was statistically significant(P<0.05). Through the correlation analysis, we can conclude that NO have positive correlation with nNOS, eNOS and iNOS (P<0.01); NO and ET-1also have positive correlation (P<0.01);It exit correlation between MDA and O2-;,·OH, H2O2.(P<0.01).Conclusions:1. The serum free radicals and ET-1are increased in severe Henoch-Schonlein purpura children,they may play a role in vasculitis.2.For severe Henoch-Schonlein purpura,the recent therapeutical effect of Hemopelfusion ally with traditional treatment is better than the alone traditional treatment.3.Hemopelfusion ally with traditional treatment can remove more effectly the serum free radicals,reduce lipid peroxide products,then mitigate the damage of the oxidatie stress to the vascular endothelial,and can reduce the serum content ET-1more effectly than the alone traditional treatment for the severe Henoch-Schonlein purpura children,so as to relieve the vasculitis symptom.