气不摄血证免疫性血小板减少症患者血管活性物质及相关炎症因子变化与临床意义  

Changes and Clinical Significance of Vasoactive Substances and Related Inflammatory Factors in Patients with Immune Thrombocytopenia with Syndrome of Qi Failing to Keep Blood

作　　者：王洪志[1] 朱世荣 胡晓梅[1] 王明镜[1,3] 谌海燕 全日城[1] 丁晓庆[4] 赵攀[1,3] 范腾[1,3] 李雨蒙 郭小青 姜云耀 Wang Hongzhi;Zhu Shirong;Hu Xiaomei;Wang Mingjing;Chen Haiyan;Quan Richeng;Ding Xiaoqing;Zhao Pan;Fan Teng;Li Yumeng;Guo Xiaoqing;Jiang Yunyao(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Beijing University of Chinese Medicine,Beijing 100029,China;Graduate School,China Academy of Chinese Medical Sciences,Beijing 100700,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京中医药大学,北京100029 [3]中国中医科学院研究生院,北京100700 [4]北京中医药大学东方医院,北京100078

出　　处：《世界科学技术-中医药现代化》2020年第3期901-906,共6页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家科学技术部国家重点基础研究发展计划(2015CB554403):气不摄血证免疫性血小板减少症的临床研究,负责人:胡晓梅。

摘　　要：目的本研究旨在探讨气不摄血证免疫性血小板减少症(immune thrombocytopenia,ITP)患者血管活性物质,以及相关炎症因子在ITP发病中的作用及其临床意义。方法气不摄血证ITP患者30例(ITP组),根据2016版ITP出血评分量表,分为未出血组、低危组(≤2分)及高危组(> 2分),健康正常人20例(对照组)。酶联免疫吸附(ELISA)法检测外周血血管活性物质一氧化氮(NO)、一氧化氮合成酶(NOS)及内皮素-1(ET-1)含量,AimPlex流式高通量技术检测外周血血管活性物质VEGF-A,VEGF-D及相关炎症因子IL-8,IL-10,IL-17A以及TNF-α含量。结果与对照组相比较,气不摄血证ITP患者NOS、VEGF-A及IL-10含量显著降低(P <0.05),ET-1、IL-8、IL-17A以及TNF-α含量显著升高(P <0.05)。同时,气不摄血证ITP患者中,高危组ET-1含量显著高于未出血组(P <0.05),ET-1、VEGF-A含量与气不摄血证ITP患者出血显著相关(OR=1.012,95%CI:0.92-1.31;OR=1.065,CI:0.98-1.22,P <0.05)。结论血管活性物质及相关炎症因子在气不摄血证ITP患者的发病过程中具有重要作用,ET-1、VEGF-A可能是反应气不摄血证ITP患者出血风险的重要客观指标。Objective To investigate the role and clinical significance of vasoactive substances and related inflammatory factors in patients with immune thrombocytopenia(ITP)with syndrome of qi failing to keep blood.Methods Thirty ITP patients with syndrome of qi failing to keep blood(trial group)were enrolled,according to the ITP bleeding score of version 2016,thirty ITP patients with syndrome of qi failing to keep blood were divided into three groups:no bleeding group,low risk group(≤2 scores)and high risk group(>2 scores),twenty healthy people served as the control group.The expressions of NO,NOS and ET-1 were detected in peripheral blood by ELISA.The expressions of IL-8,IL-10,IL-17A,TNF-α,VEGF-A and VEGF-D were detected in peripheral blood by AimPlex Multiple Immunoassays for Flow.Results As compared with the control group,the expressions of NOS,VEGF-A and IL-10 in ITP group were significantly decreased(P<0.05),while the expression of ET-1,IL-8,IL-17A and TNF-αwere significantly increased(P<0.05).Meanwhile,the expression of ET-1 in high risk group was significantly increased compared with no bleeding group(P<0.05),and the expression of ET-1 and VEGF-A were correlated with bleeding in ITP patients with syndrome of qi failing to keep blood(OR=1.012,95%CI:0.92-1.31;OR=1.065,CI:0.98-1.22;P<0.05).Conclusions Vasoactive substances and related inflammatory factors play an important role in the pathogenesis of ITP patients with syndrome of qi failing to keep blood,ET-1 and VEGF-A may be important objective indicators of the risk of bleeding in ITP patients with syndrome of qi failing to keep blood.

关 键 词：气不摄血证 免疫性血小板减少症 血管活性物质 炎症因子 

分 类 号：R242[医药卫生—中医临床基础]