目的 探讨甘露聚糖肽联合咖啡酸片治疗白细胞减少症的临床疗效。方法 选取2021年3月—2023年3月在鄂州市中心医院治疗的98例白细胞减少症患者，随机分为对照组（49例）和治疗组（49例）。对照组口服咖啡酸片，0.2 g/次，3次/d。在对照组基础上，治疗组口服甘露聚糖肽片，10 mg/次，3次/d；两组连续服药28 d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，T淋巴细胞亚群、白细胞指标，血清炎性因子白细胞介素-6（IL-6）、粒细胞集落刺激因子（G-CSF）、肿瘤坏死因子-α（TNF-α）和白细胞介素-8（IL-8）水平。结果 治疗后，治疗组患者临床有效率（97.96%）明显高于对照组（83.67%，P＜0.05）。治疗后，治疗组症状改善时间均早于对照组（P＜0.05）。治疗后，两组患者CD3^＋、CD4^＋、CD4^＋/CD8^＋、WBC指标均明显升高（P＜0.05），且治疗组这些指标明显高于对照组（P＜0.05）。治疗后，两组血清炎性因子G-CSF明显升高，而IL-6、TNF-α和IL-8水平均明显降低（P＜0.05），且治疗组明显好于对照组（P＜0.05）。结论 咖啡酸片与甘露聚糖肽协同治疗白细胞减少症效果确切，能对患者临床症状有效改善，使机体免疫能力增强，并能减弱炎性反应的能力。

Objective To explore the clinical study of mannatide combined with Caffeic Acid Tablets in treatment of leukopenia. Methods Patients (98 cases) with leukopenia in Ezhou Central Hospital from March 2021 to March 2023 were randomly divided into control (49 cases) and treatment (49 cases) group. Patients in the control group were po administered with Caffeic Acid Tablets, 0.2 g/time, three times daily. Patients in the treatment group were po administered with Mannatide Tablets on the basis of the control group, 10 mg/time, three times daily. Patients in two groups were treated for 28 d. After treatment, the clinical evaluation was evaluated, and the improvement time of symptom, the T lymphocyte subpopulations and white blood cell indicators, the levels of serum IL-6, G-CSF, and TNF-α, IL-8 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (97.96%) was significantly higher than that of the control group (83.67%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the indexes of CD3⁺, CD4⁺, CD4⁺/CD8⁺ and WBC in two groups were significantly increased (P < 0.05), and these indexes in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the levels of serum inflammatory factors G-CSF were significantly increased, while the levels of IL-6, TNF-α and IL-8 were significantly decreased in two groups (P < 0.05), and these indicators in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Caffeic Acid Tablets combined with Mannatide Tablets is effective in treatment of leukopenia, which can effectively improve the clinical symptoms, enhance the body immunity and weaken the ability of inflammatory reaction.

R973

湖北省卫生和计划生育委员会项目资助(WJ2019M072)