【摘要】 目的探讨Ｔ淋巴细胞亚群、免疫球蛋白在慢性特发性血小板减少性紫癜（ＣＩＴＰ）中的变化及其应用长春地辛（ＶＤＳ）、达那唑、左旋咪唑综合治疗对其影响和疗效。方法采用ＶＤＳ、达那唑、左旋咪唑等治疗ＣＩＴＰ，分为ＶＤＳ组及综合治疗组，分别于治疗前及治疗后４周采取静脉血标本，应用改良碱性磷酸酶－抗碱性磷酸酶（ＡＰＡＡＰ）法及琼脂单扩散法检测Ｔ淋巴细胞亚群和免疫球蛋白。结果ＣＩＴＰ患儿治疗前外周血ＣＤ４＋降低，ＣＤ８＋升高，ＣＤ４＋／ＣＤ８＋降低；治疗后ＣＤ４＋、ＣＤ８＋均降低，其中以ＣＤ８＋降低尤为显著，但ＣＤ４＋／ＣＤ８＋明显高于治疗前，ＶＤＳ组及综合组对Ｔ淋巴细胞亚群的影响无明显差异；免疫球蛋白治疗前后较正常人无明显差异。综合组有效率达 ９５％（１９／２０）， ＶＤＳ组有效率 ８０％（１６／２０），综合组疗效优于 ＶＤＳ组（Ｐ＜０． ０５）。结论 ＣＩＴＰ患儿 Ｔ淋巴细胞亚群存在表达与比例失调，ＶＤＳ等综合治疗ＣＩＴＰ能有效缓解病情。更多还原

【Abstract】 Objective: to explore the changes of Tlymphocyte subsets and immunoglobulines in CITP and the effect of VDS, Danazol and levamisole treatment. Methods: Apply VDS, Danazol and levamisole to the treatment of CITP. The Patients were divided into two groups at random. One group was treated with VDS singlely, the other with comprehensive treatment. The peripheral blood samples were collected in CITP patients before and 4 weeks after the treatment, T-lymphocyte subsets and immunoglobulines were determined by using APAAP method and agar single diffusion technique. Results: Before the treatment, these CITP patients showed an elevation in percentage of CD8+ cells, but decrease in CD4+ cells as well as ratio of CD4= /CD8 = in peripheral blood. After treatment, the expression of both CD4+ cells and CDS+ cells was profoundly inhibited, especially for CD8+ cells, while the ratio of CD4+ /CD8+ was significantly increased. There was no significant difference about T-lympho- cyte subsets between the VDS group and the comprehensive treatment group. Compared to normal group, there was no significant difference about immunoglobulines between prior and post-treatment. The effective rate of comprehensive treatment group is 95% (19/20) and that of VDS treatment group is 80% (16/20). The curative effect of the prior is better than that of the post. Conclusion: In CITP patients, T-lymphocyte subsets are abnormally distributed. The comprehensive treatment with VDS, Danazol and levamisole has beneficial effect on CITP.更多还原