维生素D3佐治初诊成人原发免疫性血小板减少症临床研究  

Clinical Study of Vitamin D3 in the Adjuvant Treatment of Adult Primary Immune Thrombocytopenia in Newly Diagnosed Patients

作　　者：李琦[1] 范凌[1] 康虹阳 张灵[1] 佟长青[1] 刘洁[1] 张斌[1] LI Qi;FAN Ling;KANG Hongyang;ZHANG Ling;TONG Changqing;LIU Jie;ZHANG Bin(The First Affiliated Hospital of the Hebei North University,Zhangjiakou,Hebei,China 075000)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《中国药业》2022年第16期89-92,共4页China Pharmaceuticals

基　　金：河北省2020年度医学科学研究课题[20200505]。

摘　　要：目的探讨维生素D_(3)佐治初诊成人原发免疫性血小板减少症(ITP)的临床疗效及对患者血清25羟维生素D_(3)[25(OH)D_(3)]和外周血淋巴细胞维生素D受体(VDR)水平的影响。方法选取医院血液科2018年1月至2019年6月收治的初诊成人ITP患者90例,按随机数字表法分为观察组和对照组,各45例。两组患者均口服醋酸泼尼松片,观察组患者加服维生素D滴剂治疗。两组患者均连续治疗4周。结果观察组总有效率为86.67%,显著高于对照组的68.89%(P<0.05)。观察组从首剂应用至获得完全反应或有效的天数为(6.48±3.75)d,显著短于对照组的(8.56±4.61)d(P<0.05)。治疗2周、4周后,两组患者血小板计数(PLT)和血清25(OH)D_(3)水平均显著高于治疗前,且观察组显著高于对照组(P<0.05);两组患者血清C反应蛋白(CRP)水平和外周血淋巴细胞VDR水平均显著低于治疗前,且观察组显著低于对照组(P<0.05);观察组患者治疗4周后以上4项指标显著优于治疗2周后(P<0.05)。治疗4周后,两组患者的ITP患者生活质量评估量表(ITP-PAQ)评分均显著高于治疗前,且观察组显著高于对照组(P<0.05)。观察组与对照组不良反应发生率相当(33.33%比28.89%,P<0.05)。随访6个月后,观察组持续有效率和复发率分别为66.67%和20.00%,显著优于对照组的28.89%和40.00%(P<0.05)。结论应用维生素D3佐治初诊成人ITP的近、远期疗效确切,其作用可能与提高患者血清25(OH)D_(3)水平和下调外周血淋巴细胞VDR表达水平有关。Objective To investigate the clinical efficacy of vitamin D_(3) in the adjuvant treatment of adult primary immune thrombocytopenia(ITP)in newly diagnosed patients and its effect on the levels of serum 25 hydroxyvitamin D_(3)[25(OH)D_(3)]and peripheral blood lymphocyte vitamin D receptor(VDR).Methods A total of 90 newly diagnosed adult patients with ITP treated in the Department of Hematology of the hospital from January 2018 to June 2019 were selected and divided into the observation group and the control group according to the random number table method,with 45 cases in each group.The patients in the two groups were treated with Prednisone Acetate Tablets,on this basis,the patients in the observation group were treated with Vitamin D Drops.Both groups were continuously treated for four weeks.Results The total effective rate in the observation group was 86.67%,which was significantly higher than 68.89% in the control group(P<0.05).The time from application of the first dose of vitamin D_(3) to complete reaction(CR)or reaction(R)in the observation group was(6.48±3.75)d,which was significantly shorter than(8.56±4.61)d in the control group(P<0.05).After two and four weeks of treatment,the platelet count(PLT)and serum 25(OH)D_(3) level in the two groups were significantly higher than those before treatment,and those in the observation group were significantly higher than those in the control group(P<0.05).The levels of serum C-reactive protein(CRP)and peripheral blood lymphocyte VDR in the two groups were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).Compared with two weeks after treatment,the above four indexes in the observation group were significantly better than those in the control group after four weeks of treatment(P<0.05).After four weeks of treatment,the scores of the ITP-Patient Assessment Question(ITP-PAQ)in the two groups were significantly higher than those before treatment,and those in the observatio

关 键 词：初诊 成人原发免疫性血小板减少症 维生素D3 25羟维生素D3 维生素D受体 临床疗效 辅助治疗 

分 类 号：R969.4[医药卫生—药理学] R973[医药卫生—药学]