目的 探討轉(zhuǎn)移因子口服液聯(lián)合重組人血小板生成素注射液治療兒童特發(fā)性血小板減少性紫癜的臨床療效。方法 選擇2017年3月—2019年3月在河南電力醫(yī)院治療的特發(fā)性血小板減少性紫癜患兒78例，根據(jù)用藥的差別分為對照組（39例）和治療組（39例）。對照組皮下注射重組人血小板生成素注射液，300 U/（kg·d），1次/d。治療組在對照組基礎(chǔ)上口服轉(zhuǎn)移因子口服液，10 mL/次，1次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，同時比較治療前后兩組患者血小板相關(guān)免疫球蛋白-G（PAIgG）、血小板相關(guān)免疫球蛋白-A（PAIgA）、血小板相關(guān)免疫球蛋白-M（PAIgM）、血小板計數(shù)，以及血清白細(xì)胞介素-2（IL-2）、IL-4、IL-6、腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，對照組臨床有效率為71.79%，顯著低于治療組的92.31%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。經(jīng)治療，兩組患者PAIgG、PAIgA、PAIgM均顯著降低（P<0.05），而血小板計數(shù)則顯著升高（P<0.05），且治療組上述指標(biāo)水平明顯好于對照組（P<0.05）。經(jīng)治療，兩組血清IL-2、IL-4、IL-6、TNF-α水平均明顯下降（P<0.05），且治療組明顯低于對照組（P<0.05）。結(jié)論 轉(zhuǎn)移因子口服液聯(lián)合重組人血小板生成素注射液治療兒童特發(fā)性血小板減少性紫癜能夠顯著改善血小板相關(guān)抗體，及血清IL-2、IL-4、IL-6、TNF-α水平，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effect of Transfer Factor Oral Solution combined with recombinant human thrombopoietin in treatment of idiopathic thrombocytopenic purpura in children. Methods Children (78 cases) with idiopathic thrombocytopenic purpura (ITP) in Henan Electric Hospital from March 2017 to March 2019 were divided into control (39 cases) and treatment (39 cases) groups based on different treatments. Children in the control group were subcutaneous injection administered with Recombinant Human Thrombopoietin Injection, 300 U/kg/d, once daily. Children in the treatment group were po administered with Transfer Factor Oral Solution on the basis of the control group, 10 mL/time, once daily. Children in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the PAIgG, PAIgA, PAIgM, platelet count, the serum level of IL-2, IL-4, IL-6 and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 71.79%, which was significantly lower than 92.31% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the PAIgG, PAIgA and PAIgM levels in two groups were significantly decreased (P<0.05), but the platelet count was significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of IL-2, IL-4, IL-6 and TNF-α in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Transfer Factor Oral Solution combined with recombinant human thrombopoietin in treatment of idiopathic thrombocytopenic purpura in children can significantly improve the platelet-related antibodies and serum levels of IL-2, IL-4, IL-6, TNF-α, which has a certain clinical application value.

R973；R985

河南省醫(yī)學(xué)科技攻關(guān)項目（201503070）