目的 探討丹參酮ⅡA磺酸鈉聯(lián)合嗎替麥考酚酯對過敏性紫癜腎炎患兒的療效及對血清轉化生長因子-β（TGF-β）及顆粒溶素（GNLY）表達水平的影響。方法 選取聊城市中醫(yī)醫(yī)院在2018年3-2019年2月收治的84例過敏性紫癜腎炎患兒為研究對象，按照隨機數(shù)字表法隨機分為觀察組與對照組，每組各42例。對照組口服嗎替麥考酚酯片，0.5 g/次，2次/d，療程持續(xù)4周。觀察組患者在對照組治療基礎上靜脈滴注丹參酮ⅡA磺酸鈉注射液，小于6歲患者20 mg/次，6至10歲患者25 mg/次，大于10歲患者40 mg/次；加入250 mL生理鹽水稀釋，1次/d，療程持續(xù)2周后停藥，同時繼續(xù)服用嗎替麥考酚酯片2周。治療4周后觀察兩組患者療效。對比兩組患者治療前后的尿常規(guī)指標、T淋巴細胞亞群水平、細胞因子水平和治療過程中的不良反應。結果 治療后，觀察組的總有效率為85.7%，明顯高于對照組的總有效率為66.7%（P<0.05）。治療后，兩組患者的尿紅細胞、尿蛋白定量較治療前顯著降低（P<0.01），尿微量白蛋白（mAlb）水平較治療前顯著升高（P<0.05）；且觀察組尿紅細胞與尿蛋白定量水平顯著低于對照組（P<0.01），mAlb顯著高于對照組（P<0.05）。治療后，兩組患者血清中CD3⁺、CD4⁺、CD4⁺/CD8⁺、NK細胞水平均高于治療前（P<0.05），且觀察組各指標在治療后明顯高于對照組（P<0.05）。治療后，兩組患者血清中白細胞介素-4（IL-4）、TGF-β水平明顯降低，γ-干擾素（IFN-γ）、IFN-γ/IL-4、GNLY水平明顯升高（P<0.05），且治療后，觀察組患者血清中IL-4、TGF-β水平明顯低于對照組，IFN-γ、IFN-γ/IL-4、GNLY水平明顯高于對照組（P<0.05、0.01）。兩組患者經(jīng)治療后，均未發(fā)生不可控的不良反應和毒副作用。結論 丹參酮ⅡA磺酸鈉聯(lián)合嗎替麥考酚酯治療過敏性紫癜腎炎患兒可顯著提高臨床療效，改善尿常規(guī)、T淋巴細胞亞群和細胞因子等相關指標，對過敏性紫癜腎炎患兒的治療具有十分重要的臨床意義。

Objective To investigate the effect of sulfotanshinone sodium combined with mycophenolate mofetil in treatment of children with allergic purpura nephritis and the expression of serumTGF-β and GNLY. Methods 84 children with allergic purpura nephritis in the Traditional Chinese Medicine Hospital of Liaocheng from March 2018 to February 2019 were randomly divided into observation group and control group, 42 cases in each group. Children in the control group were po administered with Mycophenolate Mofetil Tablets, 0.5 g/time, twice daily for 4 weeks. Children in the observation group were iv administered with Sulfotanshinone Sodium Injection on the basis of control group, children younger than 6 years old were received 20 mg/time, patients 6 to 10 years old received 25 mg/time, and patients older than 10 years old received 40 mg/time, 250 mL diluted with normal saline for once daily, the course lasted for 2 weeks, while the Mycophenolate Mofetil Tablets were continued for 2 weeks. After 4 weeks of treatment, the efficacy in two groups was observed. Urine routine indicators, T lymphocyte levels, cytokine levels and adverse reactions before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 85.7%, which was significantly higher than 66.7% of the control group (P<0.05). After treatment, urine erythrocyte and urine protein quantification in two groups were significantly lower than those before treatment (P<0.01), and mAlb level was significantly higher than that before treatment (P<0.05). And the quantitative level of urine erythrocyte and urine protein in the observation group were significantly lower than those in the control group (P<0.01), but the mAlb was significantly higher than that in the control group (P<0.05). After treatment, the serum levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ and NK cells in two groups were higher than those before treatment (P<0.05), and the indexes in the observation group were significantly higher than those in the control group after treatment (P<0.05). After treatment, the serum levels of IL-4 and TGF-β were significantly decreased in two groups, while IFN-γ, IFN-γ/IL-4, and GNLY were significantly increased (P<0.05). After treatment, the serum levels of IL-4 and TGF-β levels in the observation group were significantly lower than those in the control group, while the levels of IFN-γ, IFN-γ/IL-4, and GNLY were significantly higher than those in the control group (P<0.05). After treatment, patients in two groups did not occur uncontrollable adverse reactions and toxic side effects. Conclusions sulfotanshinone sodium combined with mycophenolate mofetil in treatment of allergic purpura nephritis patients can significantly improve the clinical curative effect, and improve the indicators of routine urine, T lymphocyte, and cytokines, and treatment of children with allergic purpura nephritis has important clinical significance.

R985