丙种球蛋白联合病毒唑治疗儿童传染性单核细胞增多症疗效及对TLR2 TLR9和T淋巴细胞亚群的影响

doi:10.3969/j.issn.1006-6233.2022.06.034

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摘要 目的: 探讨丙种球蛋白联合病毒唑治疗儿童传染性单核细胞增多症(infectious mononucleosis,IM)的疗效及对Toll样受体2(Toll-like receptors 2,TLR2)、Toll样受体9(Toll-like receptors 9,TLR9)和T淋巴细胞亚群的影响。方法: 选择本院2019年3月至2021年3月接诊的226例IM患儿,随机数字表法简单随机将患者分为对照组(n=111例)与研究组(n=115例)。对照组接受病毒唑治疗,研究组接受丙种球蛋白联合病毒唑治疗。观察两组疗效及临床表征缓解情况,并比较两组治疗前后TLR2、TLR9 mRNA表达及T淋巴细胞亚群水平(CD3⁺、CD4⁺、CD8⁺)。结果: 研究组治疗总有效率为92.17%,比对照组的81.08%高(P<0.05);研究组淋巴结减小时间、肝脾减小时间、咽峡炎缓解时间、退热时间均比对照组短(P<0.05);研究组治疗前后TLR2、TLR9 mRNA水平差值均比对照组高(P<0.05);研究组治疗前后CD3⁺、CD4⁺、CD8⁺差值均比对照组高(P<0.05)。结论: 对IM患儿进行丙种球蛋白联合病毒唑治疗具有较好治疗效果,可以明显降低机体TLR2、TLR9表达,提高免疫力。

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	李明月
	王燕
	岳敬卫

关键词 ：传染性单核细胞增多症, 儿童, T淋巴细胞亚群, 丙种球蛋白

Abstract：Objective: To investigate the efficacy of gamma globulin combined with ribavirin in the treatment of children with infectious mononucleosis (IM), and the influence on Toll-like receptor 2 (TLR2), Toll-like receptor 9 (TLR9) and T lymphocyte subsets. Methods: 226 children with IM admitted to the hospital were selected between March 2019 and March 2021. They were randomly divided into control group (111 cases) and study group (115 cases) by the random number table method. Children in the control group were treated with ribavirin, and children in the study group were treated with gamma globulin combined with ribavirin. Efficacy and clinical signs of the two groups were observed. The mRNA expression of TLR2 and TLR9, and the levels of T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺) in the two groups were compared before and after treatment. Results: The total effective rate of treatment in the study group was 92.17%, higher than 81.08% in the control group (P<0.05). The time for lymph node shrinking, time for liver and spleen shrinking, angina relief time, and fever abatement time in the study group were shorter than those in the control group (P<0.05). The difference of TLR2 and TLR9 mRNA levels in the study group before and after treatment was higher than that in the control group (P<0.05). The difference of CD3⁺, CD4⁺ and CD8⁺in the study group before and after treatment were higher than those in the control group (P<0.05). Conclusion: Gamma globulin combined with ribavirin is effective in the treatment of children with IM, which can significantly reduce the expression of TLR2 and TLR9 and improve immunity.

Key words： Infectious mononucleosis Child T lymphocyte subset Gamma globulin

基金资助:陕西省社会发展科技攻关项目,(编号:2015SF214)

通讯作者: 岳敬卫

引用本文:

李明月, 王燕, 岳敬卫. 丙种球蛋白联合病毒唑治疗儿童传染性单核细胞增多症疗效及对TLR2 TLR9和T淋巴细胞亚群的影响[J]. 河北医学, 2022, 28(6): 1032-1036.
LI Mingyue, WANG Yan, YUE Jingwei. Efficacy of Gamma Globulin Combined with Ribavirin in the Treatment of Children with Infectious Mononucleosis and Its Influence on TLR2, TLR9 and T Lymphocyte Subsets. HeBei Med, 2022, 28(6): 1032-1036.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.06.034 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I6/1032