不同剂量丙种球蛋白治疗小儿急性免疫性血小板减少症的价值  

The value of different doses of gamma globulin in the treatment of acute immune thrombocytopenia in children

作　　者：陈虹 邱忠乐 Chen Hong;Qiu Zhongle(Shangrao Maternal and Child Health Hospital,Jiangxi334000)

机构地区：[1]上饶市妇幼保健院,江西334000

出　　处：《天津药学》2023年第1期62-65,共4页Tianjin Pharmacy

摘　　要：目的:分析应用不同剂量丙种球蛋白治疗对小儿急性免疫性血小板减少症血清血小板相关抗体水平的影响。方法:选取本院2018年10月—2021年9月收治急性免疫性血小板减少症患儿60例,采用抛硬币的随机法将患儿分为观察组(n=30)和对照组(n=30),对照组给予高剂量丙种球蛋白静脉滴注,400 mg/kg,观察组给予低剂量丙种球蛋白静脉滴注,200 mg/kg,两组均每周治疗1次,共治疗4周。采用流式细胞仪检测成熟T淋巴细胞(CD3+)、辅助性T淋巴细胞(CD4+)、抑制T淋巴细胞(CD8+)水平,计算CD4+/CD8+比值,并检测白细胞计数、血红蛋白、血小板计数;采用反射免疫法测定血小板相关免疫球蛋白G(PAIgG)、血小板相关免疫球蛋白A(PAIgA)、血小板相关免疫球蛋白M(PAIgM)水平;采用酶联免疫法测定血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平,统计患儿不良反应及治疗费用。结果:两组患儿治疗前和治疗后免疫功能、实验室指标、血清血小板相关抗体水平、血清指标无明显差异(P>0.05);观察组患儿总不良反应发生率(6.66%)明显低于对照组(26.66%),且观察组患儿治疗费用也明显少于对照组(P<0.05)。结论:选用不同剂量的丙种球蛋白治疗效果是相同的,但小剂量丙种球蛋白治疗费用较高剂量丙种球蛋白更低,同时也可降低不良反应,而治疗成本减少可有效缓解部分患儿家庭负担。Objective:To analyze the effect of different doses of gamma globulin therapy on serum platelet-related antibody levels in children with acute immune thrombocytopenia.Methods:60 children with acute immune thrombocytopenia were admitted to our hospital from October 2018 to September 2021 and were randomly divided into the observation group(n=30)and the control group(n=30)by the coin toss method.The control group was given high-dose gamma globulin by intravenous drip(400 mg/kg),and the observation group was treated with low-dose gamma globulin by intravenous drip(200 mg/kg).Both groups were treated once a week for 4 weeks.The levels of mature T lymphocytes(CD3+),helper T lymphocytes(CD4+),and suppressor T lymphocytes(CD8+)were measured by flow cytometry,and the ratio of CD4+/CD8+was calculated.The white blood cell count,hemoglobin,and platelet count were also performed.The levels of platelet-associated immunoglobulin G(PAIgG),platelet-associated immunoglobulin A(PAIgA),and platelet-associated immunoglobulin M(PAIgM)were determined by reflex immunoassay.The levels of serum interleukin-6 and interleukin-10(IL-10)were determined by enzyme-linked immunosorbent,and the children's adverse reactions and treatment costs were counted.Results:There were no significant differences between the two groups in immune function,laboratory indicators,serum platelet-related antibody levels,and serum indicators before and after treatment(P>0.05).The incidence of adverse reactions in the observation group(6.66%)was significantly lower than that in the control group(26.66%),and the treatment cost of the observation group was also significantly lower than that of the control group(P<0.05).Conclusion:The therapeutic effect of different doses of gamma globulin is the same,but the treatment cost of low-dose gamma globulin is lower than that of the higher dose of gamma globulin.It can also reduce adverse reactions,and the reduction of treatment costs can effectively alleviate the family burden of some children.

关 键 词：小儿急性免疫性血小板减少症 不同剂量丙种球蛋白 血清血小板相关抗体水平 

分 类 号：R977.6[医药卫生—药品]