小牛脾提取物注射液联合糖皮质激素对原发免疫性血小板减少症患者免疫功能的影响  

Effect of calf spleen extractive injection combined with glucocorticoid on immune function of patients with primary immune thrombocytopenia

作　　者：杨翠[1] 韩效林[1] 字友梅[1] 王婉玲[1] 陈小双 李敬东[1] YANG Cui;HAN Xiaolin;ZI Youmei;WANG Wanling;CHEN Xiaoshuang;LI Jingdong(Department of Hematology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院血液科,河南卫辉453100

出　　处：《新乡医学院学报》2020年第2期136-139,共4页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关普通项目(编号:201203070)。

摘　　要：目的探讨小牛脾提取物注射液(CSEI)对原发免疫性血小板减少症(ITP)患者免疫功能的影响。方法选择2016年10月至2018年11月新乡医学院第一附属收治的初诊ITP患者65例为研究对象,根据治疗方法分为观察组(n=34)和对照组(n=31)。对照组患者给予糖皮质激素治疗,观察组患者给予糖皮质激素联合CSEI治疗。记录2组患者血小板回升时间、出血停止时间,分别于治疗前后检测患者血小板计数(BPC)、T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)、B淋巴细胞亚群(CD19^+)及自然杀伤细胞(CD56^+)水平;治疗后4周对2组患者进行疗效评估,并观察不良反应发生情况。结果观察组患者血小板回升时间、出血停止时间短于对照组(P <0. 05)。治疗前2组患者CD3^+、CD4^+、CD8^+、CD19^+、CD56^+、BPC水平及CD4^+/CD8^+比值比较差异均无统计学意义(P>0. 05)。观察组患者治疗后CD3^+、CD4^+、CD56^+、BPC水平及CD4^+/CD8^+比值高于治疗前,CD8^+水平低于治疗前(P <0. 05);观察组患者治疗前后CD19^+水平比较差异无统计学意义(P> 0. 05)。对照组患者治疗后CD4^+、CD56^+、BPC水平及CD4^+/CD8^+比值高于治疗前(P <0. 05),对照组患者治疗前后CD3^+、CD8^+、CD19^+水平比较差异均无统计学意义(P> 0. 05)。治疗后,观察组患者CD3^+、CD56^+、BPC水平及CD4^+/CD8^+比值高于对照组,CD8^+水平低于对照组(P <0. 05);2组患者治疗后CD4^+、CD19^+水平比较差异无统计学意义(P>0. 05)。观察组和对照组患者治疗总有效率分别为82.35%(28/34)、51.61%(16/31),观察组患者治疗总有效率高于对照组(χ^2=7. 006,P <0. 05)。观察组和对照组患者不良反应发生率分别为14. 71%(5/34)、19. 35%(6/31),2组患者不良反应发生率比较差异无统计学意义(χ^2=0. 249,P> 0. 05)。结论 CSEI联合糖皮质激素可以快速提升ITP患者血小板水平,改善患者免疫功能,提高治疗效果。Objective To investigate the effect of calf spleen extractive injection(CSEI) combined with glucocorticoid on immune function of patients with primary immune thrombocytopenia(ITP). Methods Sixty-five newly diagnosed ITP patients admitted to the First Affiliated Hospital of Xinxiang Medical University from October 2016 to November 2018 were selected as the study objects. The patients were divided into observation group(n = 34) and control group(n = 31) according to the treatment method. The patients in the control group were treated with glucocorticoid,while the patients in the observation group were treated with glucocorticoid and CSEI. The platelet recovery time and bleeding offtime were recorded. The levels of blood platelets count(BPC),T lymphocyte subsets(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+),B lymphocyte subsets(CD19^+)and natural killer cells(CD56^+) were measured before and after treatment. The curative effect of the patients in the two groups were evaluated at four weeks after treatment,and the adverse reactions were observed. Results The platelet recovery time and bleeding offtime in the observation group were shorter than those in the control group(P < 0. 05). There was no significant difference in the levels of CD3^+,CD4^+,CD8^+,CD19^+,CD56^+,BPC and CD4^+/CD8^+value between the two groups before treatment(P > 0. 05). Compared with before treatment,the levels of CD3^+,CD4^+,CD56^+,BPC and CD4^+/CD8^+value increased,and CD8^+level decreased after treatment in the observation group(P < 0. 05). There was no significant difference in CD19^+level before and after treatment in the observation group(P > 0. 05). The levels of CD4^+,CD56^+,BPC and CD4^+/CD8^+value after treatment were higher than those before treatment in the control group(P < 0. 05).There was no significant difference in the levels of CD3^+,CD8^+and CD19^+before and after treatment in the control group(P > 0. 05). After treatment,the levels of CD3^+,CD56^+,BPC and CD4^+/CD8^+value in the observation group were higher than those in the control group,a

关 键 词：原发免疫性血小板减少症 小牛脾提取物注射液 免疫功能 糖皮质激素 

分 类 号：R558.2[医药卫生—血液循环系统疾病]