人类免疫缺陷病毒相关免疫性血小板减少症患者糖皮质激素治疗后复发的影响因素  

Influencing factors of recurrence in patients with HIV related immune thrombocytopenia after glucocorticoid therapy

作　　者：门娅玲 何伶俐 赵春蓉 王嘉川 MEN Yaling;HE Lingli;ZHAO Chunrong;WANG Jiachuan(Department of Infection,the Second Affiliated Hospital of Chengdu Medical College(416 Hospital of Nuclear Industry),Chengdu 610000,Sichuan,China)

机构地区：[1]成都医学院第二附属医院(核工业四一六医院)感染科,成都610000

出　　处：《中国性科学》2023年第1期133-137,共5页Chinese Journal of Human Sexuality

基　　金：四川省卫生健康委员会科研课题(17PJ026)。

摘　　要：目的分析人类免疫缺陷病毒(HIV)相关免疫性血小板减少症(ITP)患者糖皮质激素治疗后复发的影响因素。方法回顾性分析2018年1月至2020年1月成都医学院第二附属医院收治的118例HIV相关ITP患者的临床资料。收集患者治疗前相关基线资料,均行抗病毒治疗及糖皮质激素治疗,随访3~12个月,记录复发情况,分析HIV相关ITP患者治疗后复发的影响因素。结果118例HIV相关ITP患者中,40例复发,78例未复发;经Logistic回归分析结果显示,病程长、中重度出血、血小板膜糖蛋白Ⅱb/Ⅲa复合物(PAC-1)高水平,T淋巴细胞亚群(CD4^(+)/CD8^(+))、血小板计数(PLT)及外周血淋巴细胞绝对值(ALC)低水平是HIV相关ITP患者治疗后复发的危险因素(OR>1,P<0.05)。结论病程长、中重度出血、PAC-1高水平,以及CD4+/CD8^(+)、PLT、ALC低水平是影响HIV相关ITP患者治疗后复发的风险因子。Objective To analyze the influencing factors of recurrence in patients with human immunodeficiency virus(HIV)related immune thrombocytopenia(ITP)after glucocorticoid therapy.Methods The clinical data of 118 patients with HIV related ITP treated in the Second Affiliated Hospital of Chengdu Medical College from January 2018 to January 2020 were retrospectively analyzed.The related baseline data of patients before treatment were collected,and they were all treated with antiviral therapy and glucocorticoid therapy.After 3-12 months of follow-up,the recurrence was recorded,and the influencing factors of recurrence in patients with HIV related ITP after treatment were analyzed.Results Among 118 patients with HIV related ITP,40 cases recurred and 78 cases did not recurred.Logistic regression analysis showed that long course of disease,moderate to severe bleeding,high level of platelet membrane glycoproteinⅡb/Ⅲa complex(PAC-1),and low levels of T lymphocyte subsets(CD4^(+)/CD8^(+)),platelet count(PLT)and absolute lymphocyte count(ALC)were risk factors for recurrence of patients with HIV related ITP after treatment(OR>1,P<0.05).Conclusions Long course of disease,moderate to severe bleeding,high level of PAC-1,and low levels of CD4^(+)/CD8^(+),PLT and ALC are risk factors that influence the recurrence of patients with HIV related ITP after treatment.

关 键 词：人类免疫缺陷病毒 血小板减少症 免疫性 糖皮质激素 复发 血小板计数 淋巴细胞绝对值 

分 类 号：R759[医药卫生—皮肤病学与性病学]