目的 探討雷公藤多苷片聯(lián)合潑尼松治療兒童自身免疫性肝炎的療效，以及其對(duì)淋巴細(xì)胞亞群的影響。方法 選取海南醫(yī)學(xué)院第二附屬醫(yī)院兒科2018年2月-2020年4月收治的自身免疫性肝炎患兒92例作為研究對(duì)象，依據(jù)治療方式將92例患兒分為對(duì)照組和觀察組，每組46例。對(duì)照組口服醋酸潑尼松龍片，2 mg/（kg·d），2次/d，最大劑量<60 mg/d。觀察組在對(duì)照組基礎(chǔ)上口服雷公藤多苷片，1 mg/（kg·d），3次/d，劑量<30 mg/d。兩組均治療3個(gè)月。觀察兩組患兒的臨床療效，比較兩組治療前后的丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）及血清免疫球蛋白（Ig） G、IgM和球蛋白水平，和調(diào)節(jié)性T細(xì)胞（Treg）和白細(xì)胞介素-10（IL-10）水平。結(jié)果 治療后，觀察組臨床治療有效率為91.3%，顯著高于對(duì)照組的74.0%（P<0.05）。治療后，兩組ALT和AST水平均顯著降低（P<0.01）；且觀察組ALT和AST水平顯著低于對(duì)照組（P<0.01）。治療后，兩組血清IgG、IgM和球蛋白均顯著降低（P<0.05），且觀察組血清IgG、IgM和球蛋白顯著低于對(duì)照組（P<0.05）。治療后，兩組Treg細(xì)胞比例和IL-10水平均顯著性升高（P<0.05），且觀察組Treg細(xì)胞比例和IL-10水平顯著高于對(duì)照組（P<0.05）。結(jié)論 雷公藤多苷片聯(lián)合潑尼松治療自身免疫性肝炎的臨床療效顯著，可顯著升高患兒Treg細(xì)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