血浆置换治疗免疫性血小板减少性紫癜疗效的影响因素  

Factors Influencing the efficacy of Plasma Exchange in the Treatment of Immune Thrombocytopenic Purpura

作　　者：顾小文[1] 尤建国[1] GU Xiao-Wen;YOU Jian-Guo(Department of Blood Transfusion,Huai'an First People's Hospital,Huai'an,Jiangsu 223300,China)

机构地区：[1]淮安市第一人民医院输血科,江苏淮安223300

出　　处：《中国实验血液学杂志》2022年第5期1567-1571,共5页Journal of Experimental Hematology

基　　金：江苏省输血协会英科新创科研基金项目(JS201290028)。

摘　　要：目的:观察血浆置换治疗免疫性血小板减少性紫癜(ITP)患者的疗效,并分析ITP经血浆置换治疗后疗效的影响因素。方法:回顾性分析2013年1月-2021年1月淮安市第一人民医院收治的39例ITP经血浆置换治疗有效的患者病历资料,设为有效组;另收集同期本院收治的39例ITP经血浆置换治疗无效的患者病历资料,设为无效组。收集并记录患者性别、年龄等一般资料和入院时的实验室指标,纳入可能的影响因素,经Logistic回归模型分析检验血浆置换治疗ITP疗效的影响因素。结果:无效组患者入院时血清白细胞介素(IL)-6、IL-18、B淋巴细胞激活因子(BAFF)水平均明显高于有效组,幽门螺杆菌(HP)感染及脾肿大占比均明显高于有效组(P<0.05),两组患者的其他资料比较差异无统计学意义(P>0.05)。经单因素分析后,建立多元回归模型分析显示,脾肿大、HP感染、入院时血清IL-6、IL-18、BAFF过表达均可能是血浆置换治疗ITP无效的影响因素(OR>1,P<0.05)。结论:入院时血清IL-6、IL-18、BAFF过表达及脾肿大、HP感染等均可能是导致ITP经血浆置换治疗后无效的影响因素。Objective:To observe the efficacy of plasma exchange in the treatment of patients with immune thrombocytopenic purpura(ITP),and to analyze the factors influencing the efficacy of plasma exchange in the treatment of ITP. Methods:The medical records of39ITP patients who were treated effectively by plasma exchange in Huai′an First People′s Hospital from January2013to January2021were retrospectively analyzed,and they were set as the effective group. In addition,the medical records of39ITP patients who were treated ineffective by plasma exchange during the same period in our hospital were collected,and they were set as the ineffective group. The general data such as sex and age of patients and laboratory indicators on admission were collected and recorded. The possible influencing factors were included,and Logistic regression analysis was used to examine the influencing factors of efficacy of plasma exchange in the treatment of ITP. Results:The serum levels of IL-6,IL-18and B lymphocyte activating factor(BAFF)on admission in the ineffective group were significantly higher than those in the effective group,and the proportions of Helicobacter pylori(HP)infection and splenomegaly were significantly higher than those in the effective group(P<0. 05). There was no statistical significantly difference in sex,age and other data between the two groups(P> 0.05).After single factor analysis,multiple regression model was established,which showed that splenomegaly,HP infection and the over expression of serum IL-6,IL-18and BAFF on admission might be the influencing factors of ineffective treatment of ITP by plasma exchange(OR> 1,P< 0.05). Conclusion:The over expression of serum IL-6,IL-18,BAFF,splenomegaly and HP infection on admission may be the influencing factors resulting in the ineffective treatment of plasma exchange in ITP.

关 键 词：免疫性血小板减少性紫癜 血浆置换 疗效 白细胞介素 B细胞激活因子 

分 类 号：R554.6[医药卫生—血液循环系统疾病]