匹多莫德对传染性单核细胞增多症患儿T淋巴细胞亚群的影响

Effects of pidotimod on T- lymphocyte subsets of EB virus children with infectious mononucleosis

目的观察匹多莫德对EB病毒(EBV)相关性传染性单核细胞增多症患儿临床疗效及T淋巴细胞亚群的动态影响。方法选择2010年07月至2013年12月期间在本院接受治疗的确诊为EBV相关性传染性单核细胞增多症患儿164例,随机分为治疗组和对照组(均n=82)。对照组患儿给予对症治疗和阿昔洛韦(250 mg·m-2,iv gtt,q8h),治疗组在对照组治疗基础上加服匹多莫德(5 mg·kg-1,po,bid)。观察治疗后临床主要症状消退时间、平均住院时间,以及治疗前后实验室检测指标、T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+等变化情况。结果治疗组发热、淋巴结肿大、异型淋巴细胞异常、咽部疼痛、肝功能异常等症状消退时间、平均住院时间较对照组显著缩短(P<0.05),临床疗效显著增高(P<0.05);咽拭子阳性率、抗EBV-CA-Ig M阳性率、抗EBV-CA-Ig G阳性率较对照组显著降低(P<0.05),抗EBV-NA-Ig G阳性率较对照组显著增高(P<0.05),治疗后第2周至第4个月CD3+较对照组显著降低(P<0.05),CD4+、CD4+/CD8+较对照组显著增高(P<0.05)。结论匹多莫德能有效改善EB病毒相关性传染性单核细胞增多症患儿的临床症状,纠正T淋巴细胞亚群失衡,缩短病程,提高临床疗效。

AIM To study on the effects of pidotimod on T-lymphocyte subsets of EB virus children with infectious mononucleosis. METHODS From July 2010 and December 2013, 164 children with the diagnosis of infectious mononucleosis of EB virus enrolled in our hospital were randomly divided into treatment group and control group, n = 82 in each. The control group was given symptomatic treatment and acyclovir 250 mg· m^-2, iv gtt, q8h. The treatment group added in the control group foundation with pidotimod 5 mg·kg^-1, po, bid. The main clinical symptoms subside time, the average hospital stay time after treatment, and the change of laboratory testing index, T lymphocyte subsets such as CD3^＋, CD4^＋, CD8^＋, CD4^＋/CD8^＋ before and after the treatment were observed. RESULTS Compared with the control group, the recovery time of fever, lymphadenectasis,heterotypic lymphocyte abnormalities, pharyngitis, abnormal liver function, and the average in hospital time in the treatment group were markedly shortened （P 〈 0.05）, and the clinical efficacy was significantly increased （P 〈0.05）. The positive rate of paper swab and the positive rate of anti EBV-CA-IgM, the positive rate of anti EBV-CA-IgG was significantly lower than the control group （P 〈 0.05）. The positive rate of anti EBV-NA-IgG was significantly higher than that of the control group （P 〈 0.05）. After treatment for two weeks to four months, CD3^＋ significantly lower than the control group （P 〈 0.05）, CD4^＋, CD4^＋/CD8^＋ were significantly higher than the control group （P 〈 0.05）. CONCLUSION Application of pidotimod in treatment of EB virus children with infectious mononucleosis can effectively improve the clinical symptom, correct the imbalance of T-lymphocyte subsets, shorten the course of disease, and improve the clinical efficacy.