艾曲泊帕对绝经伴免疫性血小板减少症患者阴道出血和血小板相关参数的影响  

Effect of Eltrombopag on vaginal bleeding and platelet-related parameters in postmenopausal patients with immune thrombocytopenia

作　　者：金珍琳[1] 金婷[2] 章瑜 庄强[1] JIN Zhen-lin;JIN Ting;ZHANG Yu;ZHUANG Qiang(Department of Hematology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China;不详)

机构地区：[1]温州医科大学附属第一医院血液内科,浙江温州325000 [2]温州医科大学附属第一医院手术室,浙江温州325000

出　　处：《中国妇幼保健》2024年第14期2566-2570,共5页Maternal and Child Health Care of China

基　　金：浙江省温州市基础性医疗卫生科技项目(Y2020548)。

摘　　要：目的 探讨艾曲泊帕对绝经伴免疫性血小板减少症(ITP)患者阴道出血及血小板相关参数的影响。方法 回顾性分析2018年11月—2022年12月温州医科大学附属第一医院收治的86例绝经伴ITP患者的一般资料,依据治疗方法将其分为对照组(47例)和艾曲泊帕组(39例)。对照组施以常规激素治疗,观察组则在此基础上加用艾曲泊帕,两组均连续治疗8周。比较两组临床疗效、治疗前后血小板计数(PLT)、凝血指标、免疫功能指标、阴道出血及不良反应发生率。结果 艾曲泊帕组治疗总有效率为94.87%,明显高于对照组的76.59%(t=5.548,P=0.018);治疗1、2、3、4、8周后,艾曲泊帕组PLT依次为(45.52±6.82)×10^(9)/L、(63.03±9.45)×10^(9)/L、(108.27±16.24)×10^(9)/L、(116.18±17.42)×10^(9)/L、(120.34±18.05)×10^(9)/L,均高于对照组的(23.37±3.50)×10^(9)/L、(34.85±5.22)×10^(9)/L、(67.16±10.07)×10^(9)/L、(74.55±11.18)×10^(9)/L、(83.27±12.49)×10^(9)/L,差异均有统计学意义(t=19.412、17.491、14.353、13.399、11.216,均P=0.000);与对照组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平[(15.28±2.29)s、(36.46±5.46)s]相比较,治疗后艾曲泊帕组PT、APTT[(12.43±1.86)s、(32.14±4.82)s]水平较低,差异有统计学意义(t=6.246、3.850,均P=0.000);治疗后艾曲泊帕组CD3^(+)、CD4^(+)及CD8^(+)水平分别为(64.29±9.64)%、(40.35±6.05)%、(32.18±4.82)%,均高于对照组的(58.44±7.86)%、(36.77±5.51)%、(27.35±4.10)%,差异均有统计学意义(t=3.100、2.869、5.021,P=0.002、0.005、0.000);治疗后艾曲泊帕组阴道出血4例(10.25%),明显低于对照组的16例(34.04%),差异有统计学意义(t=6.756,P=0.009);艾曲泊帕组和对照组不良反应发生率分别为15.38%、10.63%,两组比较差异无统计学意义(t=0.430,P=0.511)。结论 将艾曲泊帕应用于绝经伴ITP患者的治疗当中,临床效果显著,有利于缓解患者阴道出血,提高PLT,同时也能有效改善患者机体凝血功Objective To investigate the effects of Eltrombopag on vaginal bleeding and platelet-related parameters in postmenopausal patients with immune thrombocytopenia(ITP).Methods The general data of 86 postmenopausal patients with ITP admitted to The First Affiliated Hospital of Wenzhou Medical University from November 2018 to December 2022 were retrospectively analyzed.According to treatment methods,they were divided into control group(n=47)and Eltrombopag group(n=39).The control group received conventional hormone therapy,and the observation group was additionally treated with Eltrombopag.Both groups were treated continuously for 8 weeks.The clinical efficacy,platelets(PLT)before and after treatment,coagulation index,immune function index,vaginal bleeding and incidence of adverse reactions were compared between the two groups.Results The total effective rate was 94.87%,which was significantly higher than that of the control group(76.59%,t=5.548,P=0.018).After 1,2,3,4,8 weeks of treatment,The PLT of Eltrombopag group was(45.52±6.82)×10^(9)/L,(63.03±9.45)×10^(9)/L,(108.27±16.24)×10^(9)/L,(116.18±17.42)×10^(9)/L,(120.34±18.05)×10^(9)/L.They were higher than those in the control group(23.37±3.50)×10^(9)/L,(34.85±5.22)×10^(9)/L,(67.16±10.07)×10^(9)/L,(74.55±11.18)×10^(9)/L,(83.27±12.49)×10^(9)/L,the differences were all statistically significant(t=19.412,17.491,14.353,13.399,11.216,all P=0.000,);Compared with the control group[(15.28±2.29)s,(36.46±5.46)s],the levels of prothrombin time(PT)and activated partial thromboplastin time(APTT)[(12.43±1.86)s,(32.14±4.82)s]in the Eltrombopag group after treatment were lower,the differences were statistically significant(t=6.246,3.850,all P=0.000).After treatment,the levels of CD3^(+),CD4^(+) and CD8^(+) were(64.29±9.64)%,(40.35±6.05)%and(32.18±4.82)%,in the Eltrombopag group.Those in the control group were(58.44±7.86)%,(36.77±5.51)%,(27.35±4.10)%,the differences were all statistically significant(t=3.100,2.869,5.021,P=0.002,0.005,0.000).After treatment

关 键 词：免疫性血小板减少症 绝经 艾曲泊帕 阴道出血 血小板 

分 类 号：R558.2[医药卫生—血液循环系统疾病]