小剂量激素配合血小板生成素受体激动剂方案对成人急性原发性免疫性血小板减少症患者血常规及免疫球蛋白水平表达的影响  

Effect of low dose hormone combined with thrombopoietin receptor agonist regimen on blood routine and immunoglobulin level expression in adult patients with acute primary immune thrombocytopenia

作　　者：崔文婷[1] 黄燕[1] 胡苏[1] 冯波 CUIWenting;HUANG Yan;HU Su;FENG Bo(Department of Hematology,the First People's Hospital of Jiujiang,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院血液科,江西九江332000

出　　处：《当代医学》2024年第11期15-19,共5页Contemporary Medicine

摘　　要：目的探讨小剂量激素配合血小板生成素受体激动剂(TPO-RA)方案治疗成人原发性免疫性血小板减少症(ITP)患者的疗效及对患者血常规及免疫球蛋白水平表达的影响。方法选取2019年1月至2022年3月九江市第一人民医院收治的60例成人ITP患者作为研究对象,根据治疗方案的不同分为研究组与对照组,每组30例。对照组给予小剂量激素治疗,研究组给予小剂量激素配合TPO-RA方案治疗。比较两组血常规指标[血小板计数(PLT)、红细胞沉降率(ESR)]、免疫球蛋白[血小板相关免疫球蛋白A(PAIgA)、血小板相关免疫球蛋白G(PAIgG)、血小板相关免疫球蛋白M(PAIgM)]水平、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平、相关细胞[网织血小板、产板巨核细胞及巨核细胞]水平、临床疗效、不良反应发生情况及生命质量[生命质量综合评定问卷(GQOLI-74)]评分。结果治疗后,研究组PLT高于对照组,ESR低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组PAIgA、PAIgG、PAIgM水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组CD3^(+)、CD4^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组网织血小板水平低于对照组,巨核细胞数量少于对照组,产板巨核细胞水平高于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。治疗后,研究组物质生活状态、心理功能、身体功能、社会功能评分均高于对照组,差异有统计学意义(P<0.05)。结论小剂量激素配合TPO-RA方案治疗ITP疗效显著,可有效改善患者血常规与免疫球蛋白水平,提高患者生命质量,值得临床推广应用。Objective To investigate the efficacy of low dose hormone combined with thrombopoietin receptor agonist(TPO-RA)regimen on blood routine and immunoglobulin level expression in adult patients with acute primary immune thrombocytopenia(ITP).Methods A total of 60 adult patients with ITP admitted to the Jiujiang First People's Hospital from January 2019 to March 2022 were selected as study subjects,and they were divided into the study group and the control group according to different treatment plans,with 30 cases in each group.The control group was given low dose hormone therapy,and the study group was given low dose hormone therapy combined with TPO-RA regimen.The blood routine parameters(platelet count[PLT],erythrocyte sedimentation rate[ESR]),immunoglobulin(platelet-associated immunoglobulin A[PAIgA],platelet-associated immunoglobulin G[PAIgG],platelet-associated immunoglobulin M[PAIgM])levels,and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+))levels,relevant cell levels(reticular platelet,plate-producing megakaryocytes and megakaryocytes),clinical efficacy,occurrence of adverse reactions and quality of life(generic quality of life inventory-74[GQOLI-74])score were compared between the two groups.Results After treatment,PLT in the study group was higher than that in the control group,and ESR was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of PAIgA,PAIgG and PAIgM in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+)and CD4^(+)in the study group were higher than those in the control group,and the level of CD8^(+)was lower than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the level of reticular platelet in the study group was lower than that in the control group,the number of megakaryocytes was less than that in the control group,and the level of plate-producing megakaryocytes was highe

关 键 词：原发性免疫性血小板减少症 激素治疗 重组人血小板生成素 血常规 免疫球蛋白 

分 类 号：R558.2[医药卫生—血液循环系统疾病]