人免疫球蛋白联合血小板输注用于特发性血小板减少性紫癜的免疫调节作用

摘要

Objective To investigate the immune regulation effect of Platelet transfusion for idioPathic thrombocytoPenia PurPura. Methods 40 cases of children from January 2010 to October 2013 were selected and randomly divided into the control grouP and the observation grouP, 20 cases in each grouP. The two grouPs were given conventional treatment;on the basis of conventional theraPy, the observation grouP were given the Platelet transfusion 1 dose of theraPy with intravenous gamma globulin 0. 4 g/kg, and on the next day and the 3rd day received intravenous immunoglobulin 0. 4 g/ ( kg·d ) . Results After 1 course of treatment, the obvious effective rate of the ob-servation grouP was 65. 00%, and the total effective rate was 100. 00%, which were significantly higher than 25. 00% and 65. 00% of the control grouP ( P < 0. 05 );after 24 h of treatment, the Platelet count ( × 109/L ) of the observation grouP was better than that of the control grouP ( P < 0. 05 );CCI 24 ≥ 4. 5 × 109/L of the observation grouP was better than that of the control grouP ( P < 0. 05 );comPared with the control grouP, the time of hemostasis, Platelet count reaching normal, Platelet count reaching the Peak, and the Peak value of the observation grouP showed statistical differences ( P < 0. 05 );after treatment, the CD3 +, CD4 +, CD8 +, CD4 + /CD8 + of the ob-servation grouP were better than those of the control grouP ( P < 0. 05 ); the Platelet associated antibody ( PAIgG ) of the two grouPs after treatment had statistical difference comPared with before treatment ( P < 0. 05 );after treatment, the IL-4 of the observation grouP was ( 61. 19 ± 10. 42 ) ng/mL, which was lower than ( 72. 12 ± 11. 39 ) ng/mL of the control grouP ( t=4. 068, P < 0. 05 ) . Conclusion The Human Immunoglobulin combined Platelet transfusion can regulate the body's immune function of the idioPathic thrombocytoPenic PurPura Patients, and imProve the Prognosis of the Patients.%目的：观察人免疫球蛋白联合血小板输注对特发性血小板减少性紫癜的免疫调节作用。方法选择2010年1月至2013年10月收治的患者40例，随机分为对照组与观察组，每组20例。两组均给予常规治疗，观察组在常规治疗基础上，在输注血小板1个治疗剂量前予静脉滴注丙种球蛋白0.4 g/kg，次日和第3日再次予静脉滴注丙种球蛋白0.4 g/(kg·d)。结果观察组治疗1个疗程后，显效率为65.00％，总有效率为100.00％，显著高于对照组的25.00％和65.00％（ P＜0.05）；观察组治疗后24 h血小板计数优于对照组（ P＜0.05）；观察组CCI 24≥4.5×109/L的比例高于对照组（ P＜0.05）；观察组止血时间、血小板数量达正常时间、血小板数量达峰值时间和峰值与对照组比较，差异有统计学意义（ P＜0.05）；观察组治疗后CD3＋，CD4＋，CD8＋，CD4＋/CD8＋水平优于对照组（ P＜0.05）；两组治疗后血小板相关抗体（PAIgG）均下降，且观察组降幅大于对照组（ P＜0.05）；观察组治疗后白细胞介素－4（IL－4）为（61.19±10.42）ng/L，对照组为（72.12±11.39）ng/L，两组比较差异有统计学意义（ t＝4.068，P＜0.05）。结论人免疫球蛋白联合血小板输注能调节特发性血小板减少性紫癜患者机体的免疫功能，改善预后。