郑立伟,李雪峰
ZHENG Liwei,LI Xuefeng

• 1:潍坊市妇幼保健院儿一科
• 2:潍坊市妇幼保健院新生儿科

摘要(Abstract)：

目的 探讨吗替麦考酚酯（MMF）联合甲泼尼龙治疗儿童难治性过敏性紫癜（HSP）的治疗效果。方法 80例难治性HSP患儿均分对照组（MMF治疗）和观察组（MMF联合甲泼尼龙治疗），均治疗3个月；比较两组患儿的临床疗效，观察治疗前后两组患儿的血液CD3+T淋巴细胞亚群比例、CD4+T淋巴细胞亚群比例及CD8+T淋巴细胞亚群比例，检测血清白细胞介素-33(IL-33)、IL-17及肿瘤坏死因子-α(TNF-α)水平，记录两组患儿治疗期间的不良反应，评估两组药物的安全性。结果 观察组患儿治疗的总有效率高于对照组，差异有统计学意义（P<0.05）；治疗前，两组患儿CD3+T、CD4+T及CD8+T淋巴细胞亚群比例，血清L-33、IL-17及TNF-α水平比较，差异无统计学意义（P> 0.05）；治疗后两组患儿CD3+T及CD4+T淋巴细胞亚群比例水平均较治疗前升高，CD8+T淋巴细胞亚群比例及血清IL-33、IL-17、TNF-α水平较治疗前降低，这种变化在观察组更显著，差异有统计学意义（P<0.05）；两组难治性HSP患儿不良反应发生率比较，差异无统计学意义（P> 0.05）。结论 MMF联合甲泼尼龙治疗难治性HSP患儿的效果好，其机制可能与两种药物联合应用有效维持淋巴细胞亚群比例及细胞因子水平有关。
Objective To investigate the efficacy of mycophenolate mofetil(MMF) combined with methylprednisolone in the treatment of refractory allergic purpura(HSP) in children.Methods Eighty children with refractory HSP were divided into control group(MMF treatment) and study group(MMF combined with methylprednisolone), and both were treated for 3 months. The clinical efficacy,immune function( the ratio of CD3+T lymphocyte subsets, CD4+T lymphocyte subsets, CD8+T lymphocyte subsets) and serum cytokine(interleukin-33, IL-33), IL-17 and tumor necrosis factor-α( TNF-α) changes before and after treatment in both groups were compared. Recorded adverse reactions of both groups in treatment to evaluate safety of both groups of medicine.Results Total effective rate of study group was higher than control group, difference was statistically significant(P<0. 05). Before treatment, the ratio of CD3+T lymphocyte subsets, CD4+T lymphocyte subsets, CD8+T lymphocyte subsets and IL-33, IL-17, and TNF-α comparison showed no statistical significance(P> 0. 05). After treatment, ratio of CD3+T lymphocyte subsets and CD4+T lymphocyte subsets of both groups were higher than before treatment, ratio of CD8+T lymphocyte subsets and the levels of IL-33, IL-17, TNF-α were lower than before treatment, and the changes in the study group were more significant, the difference was statistically significant(P< 0. 05). There was no significant differences in the incidence of total adverse drug reactions between both groups(P> 0. 05).Conclusions MMF combined with methylprednisolone therapy in treating children with refractory HSP shows good efficacy.Such mechanism may be associated with the combined therapy effectively retained lymphocyte subsets ratio and cytokines.

关键词(KeyWords)： 吗替麦考酚酯;甲泼尼龙;过敏性紫癜;疗效;T淋巴细胞亚群;炎性因子
mycophenolate mofetil(MMF);methylprednisolone;henoch-schonlein purpura(HSP);efficacy;T lymphocyte subsets;inflammatory factors

Abstract:

Keywords:

基金项目(Foundation): 国家卫健委“十三五”规划重点课题（NHFPC102018）

作者(Author): 郑立伟,李雪峰
ZHENG Liwei,LI Xuefeng

DOI: 10.19367/j.cnki.2096-8388.2022.04.019

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