Effects of disease severity-based nursing intervention on immune function and IFN-γ, IL-6, and TNF-α for children...

The objective of this study is to study the effects of a disease severity-based nursing intervention in children with immunoglobulin A (IgA) vasculitis nephritis, including recombinant human interferon-γ (IFN-γ), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). A sample of 104 children treated at the Nephrology Department from May 2021 to May 2023 was selected for this study. The division into groups depended on distinct nursing approaches: the control group (n = 52) received conventional intervention, including basic skin care, dietary advice, and parental communication, without disease severity stratification. The research group (n = 52) received a three-level intervention (grade I, nurse-patient ratio 1:6, 12-hourly rounds, UV irradiation once daily; grade II, nurse-patient ratio 1:3, 9-hourly rounds, protein-restricted diet; grade III, nurse-patient ratio 1:1, 6-hourly rounds, liquid diet and continuous UV) based on severity. Both groups received standardized medications. Comparative analysis was conducted before intervention, 2 weeks, and 4 weeks to evaluate immune function, inflammatory factors, and renal function indicators. Initially, no statistically significant differences in immune indicators, inflammatory factors, or renal function indicators were observed in both groups (p > 0.05). After receiving care for 2 and 4 weeks, the research group displayed notably higher levels of CD3⁺ and CD4⁺ T cells in differentiated clusters (p < 0.05). Additionally, the research group demonstrated lower levels of natural killer cells, IgA, immunoglobulin G (IgG), and immunoglobulin M (IgM) (p < 0.05). Furthermore, IFN-γ, IL-6, and TNF-α levels were notably lower in the research group (p < 0.05). Key renal function indicators, including erythrocyte count, microalbuminuria (mALB), 24-h urine protein quantity, and serum β₂-microglobulin (β₂-MG), were significantly reduced in the research group (p < 0.05). Systematic hierarchical intervention tailored to disease severity may offer potential benefits in enhancing immune function, reducing inflammatory factors, and improving renal function in children with IgA vasculitis nephritis.