ITP患者外周血脂质谱与促血小板生成药物疗效的相关性分析  

The Association between Peripheral Lipid Profile and the Efficacy of Thrombopoietic Drugs in Patients with Immune Thrombocytopenia

作　　者：周心蕙 左斌[1] 王文 何杨[1] ZHOU Xinhui;ZUO Bin;WANG Wen;HE Yang(The First Affiliated Hospital of Soochow University,Suzhou 215000)

机构地区：[1]苏州大学附属第一医院,江苏苏州215000

出　　处：《临床输血与检验》2025年第1期115-120,共6页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：国家自然科学基金(No.82070123)资助。

摘　　要：目的检测免疫性血小板减少症(immune thrombocytopenia,ITP)患者外周血的脂质谱,探究脂代谢与ITP疾病的相关性。方法收集2021年1月–2023年8月于苏州大学附属第一医院血液科就诊的439例ITP患者和67例年龄与性别相匹配的健康对照者的临床资料,分析血脂生化、治疗方案、用药后血小板计数等参数与ITP疾病的相关性。根据《成人原发免疫性血小板减少症诊断与治疗中国指南》,将其中281例接受促血小板生成药物治疗的ITP患者分为有效和无效组,分析血脂水平与重组人血小板生成素(recombinant human thrombopoietin,rhTPO)/TPO受体激动剂(thrombopoietin receptor agonist,TPO-RA)疗效的相关性。结果本研究共纳入439例ITP患者和67例健康对照,ITP患者总队列和健康对照组外周血脂质水平无显著差异。281例接受rhTPO/TPO-RA治疗的ITP患者中,高甘油三酯组ITP患者rhTPO/TPO-RA治疗的起效时间更短(P=0.0283),血小板升高值显著高于低血脂组(P=0.0036)。结论高甘油三酯的ITP患者促血小板生成药物疗效较好,提示外周血脂质水平可能用于预测ITP患者rhTPO/TPO-RA疗效。Objective To explore the correlation between lipid metabolism and ITP disease,lipid profile in peripheral blood of patients with immune thrombocytopenia(ITP)was detected and analysed,then compared with control group.Methods In this retrospective study,a total of 439 ITP patients and 67 age-and gender-matched healthy controls from the First Affiliated Hospital of Soochow University between January 2021 and August 2023 were enrolled to evaluate the association between lipid profiles and immune thrombocytopenic purpura(ITP)disease activities and response to thrombopoietic drugs.Among the ITP patients,281 received rhTPO/TPO-RA treatment and were further categorized into responder and non-responder groups based on the Chinese guideline for adult ITP diagnosis and management.The correlation between blood lipid levels and rhTPO/TPO-RA efficacy in these patients was further investigated.Results A total of 439 ITP patients and 67 healthy controls were included in this study,but there was no significant difference in blood lipid levels between the two groups.Among 281 ITP patients who received rhTPO/TPO-RA treatment,the onset time of rhTPO/TPO-RA treatment was shorter(P=0.0283)and the platelet count elevation was higher(P=0.0036)in the hyperlipidemia group.Conclusion The therapeutic effect of rhTPO/TPO-RA is better in ITP patients with hyperlipidemia,suggesting that hyperlipidemia in ITP patients may serve as a predictive marker for the efficacy of rhTPO/TPO-RA treatment.

关 键 词：免疫性血小板减少症 促血小板生成药物 治疗反应 脂质谱 

分 类 号：R457[医药卫生—治疗学]