目的 探讨转移因子口服液联合重组人血小板生成素注射液治疗儿童特发性血小板减少性紫癜的临床疗效。方法 选择2017年3月—2019年3月在河南电力医院治疗的特发性血小板减少性紫癜患儿78例，根据用药的差别分为对照组（39例）和治疗组（39例）。对照组皮下注射重组人血小板生成素注射液，300 U/（kg·d），1次/d。治疗组在对照组基础上口服转移因子口服液，10 mL/次，1次/d。两组患者均治疗14 d。观察两组患者临床疗效，同时比较治疗前后两组患者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）、血小板计数，以及血清白细胞介素-2（IL-2）、IL-4、IL-6、肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，对照组临床有效率为71.79%，显著低于治疗组的92.31%，两组比较差异具有统计学意义（P<0.05）。经治疗，两组患者PAIgG、PAIgA、PAIgM均显著降低（P<0.05），而血小板计数则显著升高（P<0.05），且治疗组上述指标水平明显好于对照组（P<0.05）。经治疗，两组血清IL-2、IL-4、IL-6、TNF-α水平均明显下降（P<0.05），且治疗组明显低于对照组（P<0.05）。结论 转移因子口服液联合重组人血小板生成素注射液治疗儿童特发性血小板减少性紫癜能够显著改善血小板相关抗体，及血清IL-2、IL-4、IL-6、TNF-α水平，具有一定的临床推广应用价值。

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

河南省医学科技攻关项目（201503070）