血清免疫球蛋白水平与成人ITP患者疗效的相关性研究  

Correlation study on serum Ig levels and adult patients with immune thrombocytopenia

作　　者：宋军[1] 陈运芬[2] 郭鹏翔[1] 朱红倩[1] 王清[1] 陈驰[1] 

机构地区：[1]贵州省人民医院血液科,贵阳550002 [2]贵州省人民医院肾内科,贵阳550002

出　　处：《重庆医学》2013年第31期3771-3772,3775,共3页Chongqing medicine

基　　金：贵州省科技计划资助项目(黔科合SY[2011]3050号)

摘　　要：目的探讨血清免疫球蛋白是否有助于免疫性血小板减少(ITP)患者的治疗策略选择。方法收集该院2009年1月至2012年7月成人初诊ITP患者128例,所有患者予激素联合丙种球蛋白(IVIG)、环孢霉素A(CsA)、血小板生成因子(TPO)受体激动剂联合利妥昔单抗的阶梯式治疗,通过监测血清免疫球蛋白水平,分别比较小于或等于IgG、IGM、IgA中位数组及大于中位数组的患者对治疗方案的反应率。结果血清IgA、IgM、IgG水平与出血倾向并无相关性。低IgM水平与一线治疗抵抗相关,但对CsA及TPO受体激动剂联合利妥昔单抗治疗有反应;血清IgA水平增高往往与一线及CsA治疗抵抗相关,但对利妥昔单抗联合TPO受体激动剂治疗有反应。结论血清免疫球蛋白检测有助于成人ITP患者的治疗策略选择。Objective To investigate whether the Serum Ig is help to choose the optimal treatment in patients with immune thrombocytopenia（ITP）. Methods 128 ITP patients were collected for 3 years. All of ITP patients were treated with the step-style protocol including glueocorticoid（CsA）lombied IVIG, Ciclosporin A and TPO receptor agonist lombied rituximab. The treatment re- sponse were evaluated according the comparison between the two groups namely ≤IgG, IGM, IgA median and ≥ median groups. Results There was no relationship between the bleeding and IgA, IgM, IgG level. Low IgM level was associated with first line treatment resistance and showed the response to CsA and TPO receptor agonist lombied rituximab. High IgA level was associated with the resistance of first line and CsA treatment,but showed no response to TPO receptor agonist lombied rituximab. Conclusion Serum Ig level is helpful for the choice of optimal treatment strategies in adult ITP patients.

关 键 词：免疫性血小板减少症 治疗策略 血清免疫球蛋白 

分 类 号：R558[医药卫生—血液循环系统疾病]