重组人血小板生成素治疗老年原发免疫性血小板减少症患者的效果及对Th1/Th2相关细胞因子的影响  

Effect of recombinant human thrombopoietin on elderly patients with primary immune thrombocytopenia and its influence on Th1/Th2 related cytokines

作　　者：师铎轩 李晓梅[2] SHI Duoxuan;LI Xiaomei(Shenmu Hospital,Yulin 719300;the First Hospital of Yulin,Yulin 718000,China)

机构地区：[1]神木市医院,陕西榆林719300 [2]榆林市第一医院,陕西榆林718000

出　　处：《临床医学研究与实践》2022年第24期35-38,53,共5页Clinical Research and Practice

摘　　要：目的 分析重组人血小板生成素(rhTPO)治疗老年原发免疫性血小板减少症(ITP)的效果。方法 以我院2016年1月至2021年1月收治的90例老年原发性ITP患者为研究对象,按随机数字表法将其分为对照组(n=45,地塞米松治疗)和观察组(n=45,rhTPO治疗)。比较两组患者的临床疗效、血小板参数、辅助性T细胞1(Th1)/辅助性T细胞2(Th2)细胞因子、不良反应发生情况以及凝血功能指标。结果 观察组的治疗总有效率为93.33%,显著高于对照组的77.78%(P<0.05)。治疗后,两组患者的血小板计数(PLT)、血小板比容(PCT)、平均血小板体积(MPV)、血小板体积分布宽度(PDW)均优于治疗前,且观察组显著优于对照组(P<0.05)。治疗后,两组患者的干扰素-γ(INF-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平均优于治疗前,且观察组优于对照组(P<0.05)。观察组的不良反应总发生率为4.44%,低于对照组的28.89%(P<0.05)。治疗前、后,两组的活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)水平组间及组内比较,差异无统计学意义(P>0.05)。结论 采用rhTPO治疗老年原发性ITP的效果显著,能够调控血小板参数与Th1/Th2细胞因子,且不会对凝血功能产生不利影响,安全性较高。Objective To analyze the effect of recombinant human thrombopoietin(rhTPO) in the treatment of primary immune thrombocytopenia(ITP) in the elderly.Methods A total of 90 elderly patients with primary ITP admitted in our hospital from January 2016 to January 2021 were selected as the research objects.The patients were divided into control group(n=45,dexamethasone treatment) and observation group(n=45,rhTPO treatment) according to random number table method.The clinical efficacy,platelet parameters,helper T cell 1(Th1)/helper T cell 2(Th2) cytokines,occurrence of adverse reactions and coagulation function of the two groups were compared.Results The total effective rate of treatment in the observation group was 93.33%,which was significantly higher than 77.78% in the control group(P 0.05).Conclusion RhTPO in the treatment of primary ITP in the elderly has a significant effect,it can regulate platelet parameters and Th1/Th2 cytokines,without adverse effects on coagulation function,which has high security.

关 键 词：重组人血小板生成素 免疫血小板减少症 TH1/TH2细胞因子 

分 类 号：R558.2[医药卫生—血液循环系统疾病]