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目的比较重组血小板生成素与小剂量人血丙种球蛋白治疗特发性小儿血小板减少性紫癜的免疫学作用。方法将300例特发性小儿血小板减少性紫癜患儿随机分为A、B、C组各100例。A组给予重组血小板生成素治疗,B组给予糖皮质激素治疗,C组给予糖皮质激素联合小剂量丙种球蛋白治疗。对比观察3组患儿治疗前后白介素-10(IL-10)、细胞毒T淋巴细胞相关抗原4(CTLA-4)、转化生长因子-β1(TGF-β1)水平变化。结果治疗前3组患者血清IL-10、CTLA-4和TGF-β1水平差异均无统计学意义(P>0.05)。治疗后3组患者血清IL-10、CTLA-4和TGF-β1水平均有上升,且A、C组上升幅度均大于B组,差异均有统计学意义(P<0.05)。治疗后A组血清IL-10、CTLA-4和TGF-β1水平虽然均高于C组,但差异无统计学意义(P>0.05)。结论重组血小板生成素和小剂量人血丙种球蛋白均可改善特发性小儿血小板减少性紫癜的免疫功能。
Objective To compare the immunological effects of recombinant thrombopoietin and low dose human gamma globulin in the treatment of idiopathic thrombocytopenic purpura. Methods 300 children with idiopathic thrombocytopenic purpura were randomly divided into A, B, C group of 100 cases. A group given recombinant thrombopoietin treatment, B group given glucocorticoid treatment, C group given glucocorticoid combined with low dose gamma globulin treatment. The levels of IL-10, CTLA-4 and TGF-β1 in the three groups were compared before and after treatment. Results There was no significant difference in serum IL-10, CTLA-4 and TGF-β1 levels between the three groups before treatment (P> 0.05). After treatment, the levels of serum IL-10, CTLA-4 and TGF-β1 increased in all three groups, and the increases in groups A and C were greater than those in group B, with statistical significance (P <0.05). After treatment, the levels of serum IL-10, CTLA-4 and TGF-β1 in group A were higher than those in group C, but the difference was not statistically significant (P> 0.05). Conclusion Both recombinant thrombopoietin and low dose human gamma globulin can improve the immune function of idiopathic children with thrombocytopenic purpura.