2020 年第 11 期 第 15 卷

转移因子口服液联合更昔洛韦治疗传染性单核细胞增多症的临床效果及对患儿外周血滤泡调节性T细胞表达的影响

Clinical effect of transfer factor oral liquid combined with ganciclovir on children with infectious mononucleosis and its effect on the expression of peripheral blood follicular regulatory T cells

作者：廖亦男于四景肖耿吉

英文作者：Liao Yinan Yu Sijing Xiao Gengji

单位：湖南省儿童医院感染科，长沙410007

英文单位：Department of Infectious Disease Hunan Children′s Hospital Changsha 410007 China

关键词：传染性单核细胞增多症；转移因子口服液；更昔洛韦；临床疗效；滤泡调节性T细胞

英文关键词：Infectiousmononucleosis;Transferfactororalliquid;Ganciclovir;Clinicalefficacy;FollicularregulatoryTcells

• 摘要：

• 目的 探讨转移因子口服液联合更昔洛韦治疗传染性单核细胞增多症（IM）的临床效果及对患儿外周血滤泡调节性T细胞（Tfr）表达的影响，为临床应用提供参考依据。方法 收集湖南省儿童医院2018年4月至2019年10月收治的88例IM患儿的临床资料进行回顾性分析。根据资料中治疗方案不同分为对照组和观察组，各44例。对照组在对症治疗的基础上静脉滴注更昔洛韦治疗，观察组在对照组治疗基础上应用转移因子口服液治疗，2组均连续治疗7 d。比较2组患儿症状恢复时间、住院时间、临床疗效、T细胞亚群、Tfr表达量及不良反应发生情况。结果 观察组治疗后临床症状恢复时间、住院时间均明显短于对照组，差异均有统计学意义（均P＜0.05）。观察组总有效率明显高于对照组［93.2%（41/44）比79.6%（35/44）］，差异有统计学意义（P＜0.05）。治疗7 d末，观察组外周血CD+3、CD+4、CD+4/CD+8比值、Tfr表达量均高于对照组［Tfr表达量：（12.9±2.8）%比(8.7±2.7)%］，CD+8低于对照组，差异均有统计学意义（均P＜0.05）。2组患儿不良反应发生率差异无统计学意义［4.5%（2/44）比6.8%（3/44）］（P＞0.05）。结论 转移因子口服液联合更昔洛韦治疗IM患儿具有良好的效果，一方面可以通过调节T细胞亚群细胞数目维持机体的细胞免疫功能，另一方面可以促进Tfr分化，从而起到免疫调节的作用，且联合用药安全性良好。【

• Objective To explore the clinical effect of transfer factor oral liquid combined with ganciclovir on children with infectious mononucleosis(IM) and its effect on the expression of follicular regulatory T cells(Tfr) of peripheral blood, so as to provide reference for clinical application. Methods The clinical data of 88 children with IM admitted to Hunan Children′s Hospital from April 2018 to October 2019 were collected for retrospective analysis. According to the treatment plan in the data, they were divided into control group and observation group, with 44 cases in each group. The control group was treated with ganciclovir intravenous drip on the basis of symptomatic treatment, and the observation group was treated with transfer factor oral liquid on the basis of control group, both groups were treated continuously for 7 days. The symptom recovery time, hospitalization time, clinical efficacy, T cell subsets, expression of Tfr and adverse reactions were compared between the two groups. Results The symptoms recovery time and hospitalization time in observation group were shorter than those in the control group (both P<0.05); the total effective rate in observation group was higher than that in control group［93.2%（41/44） vs 79.6%（35/44）］, with a statistically significant difference（P＜0.05）. After 7 d of treatment, the ratio of CD+3, CD+4, CD+4/CD+8 and the expression of Tfr［（12.9±2.8）% vs (8.7±2.7)%］ in observation group were higher than those in control group(all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups［4.5%（2/44） vs 6.8%（3/44）］（P＞0.05）. Conclusions Transfer factor oral liquid combined with ganciclovir has a good effect in the treatment of children with IM.It can maintain the cellular immune function of the body by regulating the number of T cell subpopulation cells, and promote the differentiation of Tfr, so as to play the role of immune regulation. Combined of drugs can guarantee the safety of the treatment to the greatest extent.