匹多莫德在幼年特发性关节炎患儿感染预防和免疫调节中的作用分析

Effects of pidotimod on the infection prevention and immune regulations in children with juvenile idiopathic arthritis

    摘要
  • 摘要: 目的 分析匹多莫德在幼年特发性关节炎(JIA)患儿感染预防和免疫调节中的作用,为感染的预防和控制工作提供研究依据。方法 选取2015年8月-2016年8月的70例JIA患儿作为研究对象,根据治疗方案分为试验组和对照组,每组35例。对照组患儿给予常规治疗方案,试验组患儿在常规治疗方案的基础上加用口服匹多莫德治疗。对两组患儿治疗前后的CD4+T淋巴细胞比例、CD8+T淋巴细胞比例、CD4+/CD8+T淋巴细胞比值、自然杀伤细胞(NK细胞)比例及血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)水平进行检测和比较; 对两组患儿出院后连续随访12个月,对两组患儿在随访期间的感染次数、严重感染比例、单次感染持续时间进行观察和比较; 对两组患儿进行疗效评价和比较。结果 治疗后,试验组患儿的CD4+T淋巴细胞比例、CD8+T淋巴细胞比例、CD4+/CD8+T淋巴细胞比值、NK细胞比例及血清IgG、IgM、IgA水平分别为(33.62±8.22)%、(23.36±12.05)%、(1.39±0.65)、(14.31±2.03)%、(16.16±3.76)g/L、(1.82±0.43)g/L、(2.01±0.62)g/L,均优于对照组患儿的(28.76±5.64)%、(30.34±10.27)%、(1.00±0.68)、(11.05±2.71)%、(10.98±3.69)g/L、(1.19±0.45)g/L、(1.62±0.63)g/L(P＜0.05); 试验组患儿的感染次数、严重感染概率、单次感染持续时间分别为(2.92±1.53)次、11.43%、(2.65±3.92)d均低于对照组的(7.38±3.25)次、40%、(9.18±5.23)d(P＜0.05); 试验组患儿临床有效率为88.57%,高于对照组患儿的临床有效率34.29%(χ2=21.766,P＜0.001)。结论 在JIA患儿的治疗中,于常规药物疗法的基础上加用匹多莫德,能在一定程度上调节幼年特发性关节炎的免疫紊乱状态,降低感染的发生率和严重程度,有利于提高治疗依从性、确保治疗效果。

     

    Abstract: OBJECTIVE To analyze the effects of pidotimod on the infection prevention and immune regulations in children with juvenile idiopathic arthritis (JIA), so as to provide a research basis for the prevention and control of infections. METHODS 70 cases of children with JIA from Aug.2015 to Aug.2016 were selected as the research subjects and divided into the experimental group and the control group according to the treatment plan, with 35 cases in each group.The children in the control group were treated with the conventional treatments, while the patients in the experimental group were treated with combined pidotimod oral solution on the basis of the conventional treatment.The CD4+T lymphocyte percentages, the CD8+T lymphocyte percentages, the CD4+/CD8+T lymphocyte ratios, the natural killer cell (NK cell) percentages and the serum levels of immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA) of the children in the two groups before and after the treatment were determined and compared.The children in the two groups were followed up continuously for 12 months, the times of infections, the ratios of serious infections, the duration of single infection of the children in the two groups were observed and compared.The therapeutic effects of the two groups were evaluated and compared. RESULTS After the treatment, the CD4+T lymphocyte percentages, the CD8+T lymphocyte percentages, the CD4+/CD8+T lymphocyte ratios, the NK cell percentages and the serum levels of IgG, IgM, IgA in the experimental group were (33.62±8.22)%, (23.36±12.05)%, (1.39±0.65), (14.31±2.03)%, (16.16±3.76) g/L, (1.82±0.43) g/L, (2.01±0.62) g/L respectively, which were significantly better than (28.76±5.64)%, (30.34±10.27)%, (1.00±0.68), (11.05±2.71)%, (10.98±3.69) g/L, (1.19±0.45) g/L, (1.62±0.63) g/L in the control group (P＜0.05).The times of infections, the ratios of serious infections, the duration of single infection of the children in the experimental group were (2.92±1.53) times, 11.43%, (2.65±3.92)d respectively, which were significantly lower than (7.38±3.25) times, 40%, (9.18±5.23) d in the control group (P＜0.05).The clinical effective rate of the experimental group was 88.57%, which was significantly higher than the clinical effective rate of the control group (34.29%) (χ2=21.766, P＜0.001). CONCLUSION In the treatment of children with JIA, the application of combined pidotimod treatment on the basis of the conventional drug therapy can relieve the children's immune suppression, reduce the incidence and severity of the infections, which helps to improve treatment compliance and ensure the treatment effects.

     

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