重组人血小板生成素治疗老年免疫性血小板减少症的疗效与安全性分析及对Th1/Th2相关细胞因子的调控作用研究  

Analysis of the efficacy and safety of recombinant human thrombopoietin in the treatment of senile immune thrombocytopenia and study on its regulatory effect on Th1/Th2 related cytokines

作　　者：陶红[1] 何正梅[1] 史玉叶[1] 陈秋妮 吴晶晶[1] 陶善东[1] 张权娥 王春玲[1] TAO Hong;HE Zhengmei;SHI Yuye;CHEN Qiuni;WU Jingjing;TAO Shandong;ZHANG Quan'e;WANG Chunling(Department of Hematology,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Jiangsu,Huai'an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院血液科,江苏淮安223300

出　　处：《中国医药科学》2021年第2期22-24,29,共4页China Medicine And Pharmacy

摘　　要：目的分析重组人血小板生成素(rhTPO)治疗老年ITP患者的疗效与安全性,及对Th1/Th2相关细胞因子的调控作用。方法收集2015年1月至2020年1月南京医科大学附属淮安第一医院收治的123例老年初诊ITP患者为研究对象,以简单随机法分为rhTPO组[62例,皮下注射rhTPO 300 U/(kg·d),疗程14 d]激素组[61例,静脉滴注泼尼松1.0 mg/(kg·d),疗程28 d],对比两组疗效及不良反应。以同期健康体检的100例老年人群为对照组,观察rhTPO组治疗前后Th1/Th2相关细胞因子变化。结果rhTPO组第7天及第14天血小板水平显著高于激素组(P=0.011,P=0.001),总体有效率高于激素组(P=0.020),不良反应发生率低。与对照组比较,rhTPO组治疗后Th1优势反应消失,Th1/Th2相关细胞因子发生变化。结论rhTPO治疗老年ITP患者的疗效与安全性确切,作用机制与调控Th1/Th2相关细胞因子有关。Objective To analyze the efficacy and safety of recombinant human thrombopoietin(rhTPO)in the treatment of elderly patients with immune thrombocytopenia(ITP),and its regulatory effect on Th1/Th2 related cytokines.Methods A total of 123 elderly patients who were newly diagnosed with ITP in the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University hospital from January 2015 to January 2020 were collected as the research objects.They were divided into the rhTPO group(n=62,to receive subcutaneous injection of rhTPO 300 U/[kg·d]for 14 days)and the hormone group(n=61,to receive intravenous infusion of prednisone 1.0 mg/[kg·d]f o r 28 days)with a simple randomization method.The efficacy and adverse reactions were compared between the two groups.100 elderly people who received physical examination during the same period were selected as the control group.The changes in Th1/Th2 related cytokines in the rhTPO group before and after treatment were observed.Results The platelet levels on Day 7 and Day 14 in the rhTPO group were significantly higher than those in the hormone group(P=0.011,P=0.001),the overall effective rate was higher than that in the hormone group(P=0.020),and the incidence of adverse reactions was lower.Compared with the control group,the Th1 dominant response disappeared after treatment in the rhTPO group,and Th1/Th2 related cytokines changed.Conclusion rhTPO has definite efficacy and safety in the treatment of elderly patients with ITP,and the mechanism of action is related to the regulation of Th1/Th2 related cytokines.

关 键 词：老年 免疫性血小板减少症 重组人血小板生成素 糖皮质激素 细胞因子策 

分 类 号：R5582[医药卫生—血液循环系统疾病]