大剂量地塞米松联合重组人血小板生成素治疗原发免疫性血小板减少症41例  

High Dose Dexamethasone Combined with Recombinant Human Thrombopoietin in the Treatment of 41 Cases of Primary Immune Thrombocytopenia

作　　者：纪国超[1] JI Guochao(Puyang People's Hospital,Puyang Henan 457000,China)

机构地区：[1]濮阳市人民医院,河南濮阳457000

出　　处：《药品评价》2021年第16期1010-1012,共3页Drug Evaluation

摘　　要：目的:研究大剂量地塞米松联合重组人血小板生成素(rhTPO)治疗原发免疫性血小板减少症(ITP)患者的临床疗效。方法:选取濮阳市人民医院2019年6月至2020年9月ITP患者82例,根据治疗方案不同分为对照组(41例)和观察组(41例)。两组均给予常规干预治疗,对照组采用大剂量地塞米松治疗,观察组采用rhTPO+大剂量地塞米松治疗。比较两组临床疗效、血小板计数(PLT)、白细胞介素-10(IL-10)、细胞毒T淋巴细胞相关抗原4(CTLA-4)、转化生长因子-B1(TGF-β1)、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))、不良反应。结果:治疗后,观察组临床疗效92.68%高于对照组65.85%(P<0.05);治疗后观察组PLT、IL-10、CTLA-4、TGF-β1均高于对照组(P<0.05);治疗后观察组CD3^(+)、CD4^(+)均高于对照组,CD8^(+)低于对照组(P<0.05);两组治疗后不良反应对比差异无统计学意义(P>0.05)。结论:大剂量地塞米松+rhTPO治疗ITP患者临床疗效确切,可有效提升患者血小板水平,调节免疫细胞因子,且安全性良好。Objective:To study the clinical effect of high dose dexamethasone combined with recombinant human thrombopoietin(rhTPO)in the treatment of primary immune thrombocytopenia(ITP).Methods:82 patients with ITP were selected(June 2019-September 2020),and were divided into control group(41 cases)and observation group(41 cases)according to the treatment scheme.The two groups were treated with conventional intervention,the control group was treated with high-dose dexamethasone,and the observation group was treated with rhTPO+high dose dexamethasone.To compare the clinical efficacy,PLT,IL-10,CTLA-4,TGF-β1,T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+)),adverse reactions.Results:After treatment,the clinical efficacy of 92.68%in observation group was higher than that of 65.85%in control group(P<0.05);after treatment,PLT,IL-10,CTLA-4 and TGF-β1 in observation group were higher than that of control group(P<0.05);after treatment,the CD3^(+)and CD4^(+)in the observation group were higher than that of the control group,and CD8^(+)was lower than that of the control group(P<0.05);there was no significant difference in the adverse reactions between the two groups(P>0.05).Conclusion:The high dose dexamethasone+rhTPO has a good clinical effect on ITP patients,which can effectively improve the platelet level and regulate the immune cytokines,and it is safe.

关 键 词：血小板减少症 地塞米松 重组人血小板生成素 转化生长因子Β1 

分 类 号：R558.2[医药卫生—血液循环系统疾病]