目的 探讨雷公藤多苷片联合泼尼松治疗儿童自身免疫性肝炎的疗效，以及其对淋巴细胞亚群的影响。方法 选取海南医学院第二附属医院儿科2018年2月-2020年4月收治的自身免疫性肝炎患儿92例作为研究对象，依据治疗方式将92例患儿分为对照组和观察组，每组46例。对照组口服醋酸泼尼松龙片，2 mg/（kg·d），2次/d，最大剂量<60 mg/d。观察组在对照组基础上口服雷公藤多苷片，1 mg/（kg·d），3次/d，剂量<30 mg/d。两组均治疗3个月。观察两组患儿的临床疗效，比较两组治疗前后的丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）及血清免疫球蛋白（Ig） G、IgM和球蛋白水平，和调节性T细胞（Treg）和白细胞介素-10（IL-10）水平。结果 治疗后，观察组临床治疗有效率为91.3%，显著高于对照组的74.0%（P<0.05）。治疗后，两组ALT和AST水平均显著降低（P<0.01）；且观察组ALT和AST水平显著低于对照组（P<0.01）。治疗后，两组血清IgG、IgM和球蛋白均显著降低（P<0.05），且观察组血清IgG、IgM和球蛋白显著低于对照组（P<0.05）。治疗后，两组Treg细胞比例和IL-10水平均显著性升高（P<0.05），且观察组Treg细胞比例和IL-10水平显著高于对照组（P<0.05）。结论 雷公藤多苷片联合泼尼松治疗自身免疫性肝炎的临床疗效显著，可显著升高患儿Treg细胞比例和IL-10因子水平，使用安全。

Objective To investigate the efficacy of Tripterygium Glycosides Tablets combined with prednisone in treatment of children with autoimmune hepatitis and its effect on lymphocyte subsets. Methods A total of 92 children with autoimmune hepatitis admitted to the Second Affiliated Hospital of Hainan Medical College from February 2018 to April 2020 were selected as the research subjects. According to the treatment methods, the 92 children were divided into control group and observation group, with 46 cases in each group. Children in the control group were po administered with Prednisolone Acetate Tablets, 2 mg/(kg·d), twice daily, with the maximum dose < 60 mg/d. Children in the observation group were po administered with Tripterygium Glycosides Tablets on the basis of control group, 1 mg/(kg·d), three times daily, dose less than 30 mg per day. Both groups were treated for 3 months. The clinical efficacy of two groups was observed. The levels of ALT, AST, IgG, IgM, globulin, Treg and IL-10 before and after treatment were compared between two groups. Results After treatment, the clinical effective rate of observation group was 91.3%, which was significantly higher than 74.0% of control group (P<0.05). After treatment, ALT and AST levels in two groups were significantly decreased (P<0.01), but the levels of ALT and AST in observation group were significantly lower than those in control group (P<0.01). After treatment, serum IgG, IgM and globulin in two groups were significantly decreased (P<0.05), and the serum IgG, IgM and globulin in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the proportion of Treg cells and the level of IL-10 in two groups were significantly increased (P<0.05), and the proportion of Treg cells and the level of IL-10 in the observation group were significantly higher than those in the control group (P<0.05). Conclusion Tripterygium Glycosides Tablets combined with prednisone has significant clinical efficacy in treatment of autoimmune hepatitis, which can significantly increase the proportion of Treg cells and the level of IL-10 factor in children, and it is safe to use.

R979.5