Effects Of "cocktail" Therapy On PLT, Thl7 And Treg Cells In Children With Persistent And Chronic Thrombocytopenia

PurposeObserve the clinical effect of "cocktail" therapy against persist and chronic immune thrombocytopenia (ITP). Conceive of the T helper cell(Th) and regulatory T cells(Treg) as the breakthrough point,from the perspective of cellular immunity to explore the pathogenesis of persist and chronic ITP and comparing the changes of the platelet and Th17/Treg in ITP patients before and after "cocktail" therapy,to explain the pathogenesis of ITP and to provide persist and chronic ITP children patients with guiding treatment and effective methods.MethodUsing the "cocktail" therapy to treat the 22 persist and chronic ITP children who are the research objects. The boys are 9,and the girls are 13,the age from 2 to 11 years old,the mean age is (6.14±2.91)years old,time of therapy is 12 weeks.Using automatic blood cell analyzer to detect blood platelet count(BPC)of ITP patients,applying flow cytometry(FCM)to test interleukin-17(IL-17)and forkhead box p3(Foxp3),making use of standard of ITP bleeding classification to evaluate bleeding symptoms changes.Using statistical analysis software SPSS 19.0 analysis the experiment datas to understand the ITP efficiency and pathogenesis with "cocktail" therapy.Results1、"Cocktail" therapy for children of persist and chronic ITP have a satisfaction effect, treatment for 12 weeks, the total effective rate is 63.6%, fully reflect rate is 54.5%, effective rate is 9.1%.12 cases are followed up for another 4 weeks, completing follow-up (12/22), the total effective rate is 66.7%;2、Experiments confirms that Th17/Treg (IL-17, Foxp3) are imbalance in the children patients with ITP, to Th17 drift, after 12 weeks treatment,Th17/Treg (IL-17, Foxp3) has different degrees of improvement;3、With "cocktail" therapy, the bleeding symptoms of skin and mucous membrane have a great improvement among all patients, ITP bleeding classification scores decline, and the scores from the 2 drops to 0 are 10.5%, the scores of changing from grade 2 to grade 1 and from grade 1 to grade 0 are 63.2%.4、"Cocktail" therapy is safe in the treatment of 22 children patients, found no obvious side effects, some patients with mild adverse reactions, such as dry stool, oral ulcer, after adjusting the doses of medicine or diet aftercare the symptoms can improve.ConclusionIt is found that the level of Th17 improves and the level of Treg drops, Th17/Treg appears unbalanced and Th17 drift in the children patients of ITP, hints that immune tolerance loss caused by Th17/Treg imbalance plays an important role in persist and chronic ITP. After 12 weeks treatment, the platelet counts in patients with ITP children rise, the total effective rate is 63.6%, the clinical curative effect. By comparing the changes of the level before and after treatment in ITP patients with Th17 and Treg (IL-17, Foxp3), discoves that Th17/Treg (IL-17, Foxp3) have different degrees of improvement,suggests the mechanism of "cocktail" therapy treatment ITP may lie in changing Th17 and Treg level, correcting Th17/Treg imbalance can return to normal levels of immune tolerance.After "cocktail" therapy, patients with ITP skin mucous membrane bleeding reduces, and the ITP bleeding classification score reduces, states "cocktail" therapy can improve the platelet function,and improve symptoms of hemorrhage in patients with ITP. In treatment process, found no obvious side effects, that is to say"cocktail" therapy is safe.