目的 探讨艾曲泊帕乙醇胺片对特发性血小板减少性紫癜（ITP）患儿CD40/CD40L轴的影响机制。 方法 选取80例ITP患儿作为研究对象，根据数字随机表法将其分为对照组（n = 40）和研究组（n = 40）。对照组给予环孢素治疗，研究组给予艾曲泊帕乙醇胺片治疗，两组均连续治疗3个月。对比两组患者的临床疗效、T淋巴细胞亚群水平（CD3⁺、CD4⁺和CD4⁺/CD8⁺）以及不良反应。检测两组患者淋巴细胞膜表面和血小板膜表面的CD40、CD40L水平，使用ELISA检测血浆sCD40和sCD40L水平。 结果 研究组的总有效率（92.50%）明显高于对照组的总有效率（75.00%）（P < 0.05）。两组治疗后的CD3⁺、CD4⁺、CD4⁺/CD8⁺、血浆sCD40表达水平均高于治疗前，CD8⁺以及外周血CD19⁺ CD40⁺、CD3⁺ CD40L⁺细胞和血浆sCD40L表达水平低于治疗前；研究组CD3⁺、CD4⁺、CD4⁺/CD8⁺、血浆sCD40表达水平高于对照组，CD8⁺以及外周血CD19⁺ CD40⁺、CD3⁺ CD40L⁺细胞和血浆sCD40L表达水平低于对照组（P < 0.05）。两组治疗后的外周血血小板膜表面的CD40L⁺细胞低于治疗前；研究组的外周血血小板膜表面的CD40⁺高于对照组，CD40L⁺细胞低于对照组（P < 0.05）。研究组的总不良率（15.00%）低于对照组的总不良率（22.50%），但是两组比较差异无统计学意义（P > 0.05）。 结论 艾曲泊帕乙醇胺片治疗ITP患儿具有良好的临床疗效，调节T淋巴细胞亚群水平，安全性良好。

Objective To explore the mechanism of the effect of itraconazole ethanolamine tablets on the CD40/CD40L axis in children with idiopathic thrombocytopenic purpura （ITP）. Methods 80 children with ITP were selected as the study subjects. They were divided into a control group （n = 40） and a study group （n = 40） using a digital random table method. The control group was treated with cyclosporine， while the study group was treated with itraconazole ethanolamine tablets. Both groups were treated continuously for 3 months. Compare the clinical efficacy of two groups of patients T lymphocyte subpopulation levels ［CD3⁺ CD4⁺ and CD4⁺/CD8⁺， as well as adverse reactions. Detect CD40 on the surface of lymphocyte membrane and platelet membrane in two groups of patients CD40L level， plasma sCD40 and sCD40L levels were detected using ELISA. Results The total effective rate of the study group （92.50%） was significantly higher than that of the control group （75.00%） （P < 0.05）. CD3⁺ CD4⁺，CD4⁺/CD8⁺， The expression levels of sCD40 in plasma were higher than before treatment， CD8⁺ and peripheral blood CD19⁺ CD40⁺ The expression levels of CD3⁺， CD40L⁺ cells， and plasma sCD40L were lower than before treatment； Research group CD3⁺ CD4⁺， CD4⁺/CD8⁺， The expression level of sCD40 in plasma was higher than that in the control group， CD8⁺， And peripheral blood CD19⁺ CD40⁺ The expression levels of CD3⁺ CD40L⁺ cells and plasma sCD40L were lower than those of the control group （P < 0.05）. The CD40L⁺ cells on the surface of peripheral blood platelet membranes after two treatment groups were lower than before treatment； The CD40⁺ on the surface of peripheral blood platelet membrane in the study group was higher than that in the control group， CD40L⁺ cells were lower than those in the control group （P < 0.05）. The total adverse rate of the study group （15.00%） was lower than that of the control group （22.50%）， but there was no significant difference between the two groups （P > 0.05）. Conclusion The treatment of ITP in children with eltrombopag olamine tablets has good clinical efficacy， regulates the level of T lymphocyte subsets， and is safe.