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目的探讨Ｔ淋巴细胞亚群、免疫球蛋白在慢性特发性血小板减少性紫癜（ＣＩＴＰ）中的变化及其应用长春地辛（ＶＤＳ）、达那唑、左旋咪唑综合治疗对其影响和疗效。方法采用ＶＤＳ、达那唑、左旋咪唑等治疗ＣＩＴＰ，分为ＶＤＳ组及综合治疗组，分别于治疗前及治疗后４周采取静脉血标本，应用改良碱性磷酸酶－抗碱性磷酸酶（ＡＰＡＡＰ）法及琼脂单扩散法检测Ｔ淋巴细胞亚群和免疫球蛋白。结果ＣＩＴＰ患儿治疗前外周血ＣＤ４＋降低，ＣＤ８＋升高，ＣＤ４＋／ＣＤ８＋降低；治疗后ＣＤ４＋、ＣＤ８＋均降低，其中以ＣＤ８＋降低尤为显著，但ＣＤ４＋／ＣＤ８＋明显高于治疗前，ＶＤＳ组及综合组对Ｔ淋巴细胞亚群的影响无明显差异；免疫球蛋白治疗前后较正常人无明显差异。综合组有效率达 ９５％（１９／２０）， ＶＤＳ组有效率 ８０％（１６／２０），综合组疗效优于 ＶＤＳ组（Ｐ＜０． ０５）。结论 ＣＩＴＰ患儿 Ｔ淋巴细胞亚群存在表达与比例失调，ＶＤＳ等综合治疗ＣＩＴＰ能有效缓解病情。
Objective To investigate the changes of T lymphocyte subsets and immunoglobulins in patients with chronic idiopathic thrombocytopenic purpura (CITP) and its effect and efficacy on VDS, danazol and levamisole combined therapy. Methods CITP was treated with VDS, danazol and levamisole. The patients were divided into VDS group and comprehensive treatment group. Venous blood samples were taken before treatment and 4 weeks after treatment respectively. The patients were treated with modified alkaline phosphatase-anti-alkaline phosphatase APAAP) method and single agar diffusion method to detect T lymphocyte subsets and immunoglobulins. Results The levels of CD4 +, CD8 +, CD4 + / CD8 + were decreased in peripheral blood of CITP children before treatment. The levels of CD4 + and CD8 + were decreased after treatment, especially in CD8 + cells. CD4 + / CD8 + T lymphocyte subsets no significant difference in the impact; immunoglobulin before and after treatment compared with normal no significant difference. The effective rate was 95% (19/20) in the comprehensive group, 80% (16/20) in the VDS group and superior to the VDS group (P <0.05). Conclusion The expression and proportion of T lymphocyte subsets in children with CITP are imbalanced. CITP such as VDS can effectively relieve the disease.