不同剂量人免疫球蛋白联合糖皮质激素治疗免疫性血小板减少症对患儿外周血Th17细胞水平的影响

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Abstract Objective To investigate the effects of high-dose immunoglobulin combined with glucocorticoids on peripheral blood Th17 cell levels in children with immune thrombocytopenia（ITP）.Methods A total of 78 children with ITP who were admitted were enrolled.Using random number table method,they were divided into medium-dose group（routine-dose immunoglobulin and glucocorticoid,n=38） and high-dose group（high-dose immunoglobulin combined with glucocorticoid,n=40）.The clinical effects of the two groups were compared.Changes in levels of peripheral blood helper T cell 17（Th17） and regulatory T cells（Treg） before and after treatment in both groups were observed.Th17/Treg was calculated,and drug safety of the two groups was compared.Results The total effective rate in the high-dose group was significantly higher than that in the middle-dose group（P<0.05）.Compared with the same group before treatment,Th17 and Th17/Treg in the two groups after treatment were obviously decreased,while Treg was significantly increased;however,Th17 and Th17/Treg in the high-dose group after treatment were significantly lower than those in the middle-dose group,while Treg was significantly higher than that in the middle-dose group（P<0.05）.There was no significant difference in the total incidence of adverse reactions between the two groups [17.50%（7/40） vs 10.53%（4/38）]（χ²=0.782,P>0.05）.Conclusion High dose immunoglobulin combined with glucocorticoid in the treatment of immune thrombocytopenia has a significant clinical effect and high safety,which can effectively change the content of Th17 and Treg,regulate the balance of Th17/Treg cells.

Key words： Immune thrombocytopenia Immunoglobulin High-dose Glucocorticoid Th17

Received: 19 November 2020

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Huang Xiaolong. Influence of High-Dose Immunoglobulin Combined With Glucocorticoids on Peripheral blood Th17 Cell Levels in Children With Immune Thrombocytopenia[J]. journal1, 2021, 41(1): 3-5.

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http://www.hrbyybjb.org.cn/EN/ OR http://www.hrbyybjb.org.cn/EN/Y2021/V41/I1/3

[1] Cervantes F,Montserrat E,Rozman C,et al.Low-dose vincristine in the treatment of corticosteroid-refractory idiopathic thrombocytopenic purpura(ITP)in non-splenectomized patients[J].Postgraduate Medical Journal,2018,56(660):711-714.
[2] 黄炜祺,周咏明.原发免疫性血小板减少症的免疫机制研究进展[J].中国实验血液学杂志,2019,27(4):1321-1324.
[3] Takase K,Kada A,Iwasaki H,et al.High-dose dexamethasone therapy as the initial treatment for idiopathic thrombocytopenic purpura: protocol for a multicenter,open-label,single arm trial[J].Acta Medica Okayama,2018,72(2):197-201.
[4] 高伟波,石茂静,黄文凤,等.59例血栓性血小板减少性紫癜患者临床分析[J].中华急诊医学杂志,2020,29(1):106-111.
[5] 蔡文仙,舒志荣,王瑜,等.大剂量静脉注射免疫球蛋白对特发性血小板减少性紫癜患儿中性粒细胞的影响[J].中国实用儿科杂志,2008,23(10):798-798.
[6] 何静,徐松,谢国燕.免疫球蛋白治疗儿童ITP的机制及其改善患者生活质量的初探[J].免疫学杂志,2019,19(11):19-21.
[7] 郑秀兰. 小儿特发性血小板减少性紫癜的药物联合治疗[J].哈尔滨医药,2011,34(5):341.
[8] 周正菊,张友山,梁彩霞,等.ITP患者外周血Th9,Th17和Treg细胞水平及IL-9,IL-17和TGF-β表达在ITP发病中的作用[J].中国实验血液学杂志,2019,137(1):192-196.
[9] 王潇. Th17细胞在特发性血小板减少性紫癜发病中的作用及肿节风对其影响的研究[D].浙江:浙江中医药大学,2013.
[10] 何海燕,张明真,禤瑞华.不同剂量丙种球蛋白联合激素治疗小儿特发性血小板减少性紫癜疗效的对比[J].血栓与止血学,2018,24(5):356-358.
[11] 孙志强,徐芳芳,郑方,等.原发免疫性血小板减少症患者Th17细胞和调节性T细胞检测的意义[J].中华临床医师杂志(电子版),2017,11(2):208-212.
[12] 归舸,蒋璐灿,张伶俐,等.全球现有儿童特发性血小板减少性紫癜指南的循证评价[J].中国药房,2018,29(4):541-546.
[13] 李颢,姜海华,王新伟.外周血Th17细胞对大剂量地塞米松治疗免疫性血小板减少症长期疗效的预测价值[J].安徽医药,2019,23(3):517-519.
[14] 车蕾,周泽平.多药联合治疗ITP的进展[J].中国免疫学杂志,2019,35(8):109-112.