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投稿时间：2020-05-10 网络发布日期：2020-12-20
投稿时间：2020-05-10 网络发布日期：2020-12-20
中文摘要: 目的 探讨抗幽门螺旋杆菌(Hp)治疗联合重组人血小板生成素(rhTPO)对难治性特发性血小板减少性紫癜(ITP)患者辅助性T细胞1/辅助性T细胞2(Th1/Th2)细胞因子的影响。方法 选择2008年6月至2018年6月收治的71例难治性ITP患者为研究对象进行回顾性研究，按照治疗方案的不同将患者分为对照组(n=36)及观察组(n=35)。对照组给予rhTPO治疗，观察组在对照组治疗的基础上使用抗Hp治疗，两组均连续治疗2周。统计两组患者治疗2周后临床疗效;比较两组患者治疗前与治疗后Th1细胞因子［白细胞介素(IL)-2、γ-干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)］和Th2细胞因子(IL-4、IL-10)、B淋巴细胞(CD19+、B1细胞)与血小板(PLT)计数;比较治疗后1年内两组患者的复发率。结果 治疗2周后，观察组总有效率高于对照组(94.29% vs 69.44%，P<0.01)。治疗2周后，两组IFN-γ、TNF-α、IL-2、IL-2/IL-4、CD19+、B1水平均较治疗前降低，且观察组低于对照组(P<0.05，P<0.01);IL-4、IL-10、PLT水平均较治疗前升高，且观察组高于对照组(P<0.05，P<0.01)。随访1年内观察组总复发率低于对照组(21.21% vs 48.00%，P<0.05)。结论 抗Hp联合rhTPO治疗难治性ITP患者可显著提高临床疗效，升高PLT，调节Th1/Th2免疫平衡，缓解临床症状，改善预后。
Abstract:Objective To explore the effect of anti-Helicobacter pylori(Hp) therapy combined with recombinant human thrombopoietin (rhTPO) on T helper type 1/T helper type 2 (Th1/Th2) cytokines in patients with refractory idiopathic thrombocytopenic purpura (ITP). Methods Seventy-one patients with refractory ITP treated from June 2008 to June 2018 were enrolled for retrospective study and were divided into control group(n=36) and observation group (n=35) according to different treatment schemes.The rhTPO were given in both groups, while anti-Hp was added in observation group.Before and after 2 weeks of treatment, the levels of interleukin(IL)-2, IL-4、IL-10, interferon-gamma(IFN-γ), tumor necrosis factor-α (TNF-α), CD19+, B1 cells and platelet count(PLT) were compared between two groups.The recurrence rate within 1 year after treatment was compared between two groups. Results The total effective rate in observation group was significantly higher than that in control group(94.29% vs 69.44%, P<0.01).At two weeks after treatment, the levels of IFN-γ, TNF-α, IL-2, IL-2/IL-4, CD19+ and B1 cells were significantly lower than those before treatment in two groups and were significantly lower in observation group than those in control group (P<0.05, P<0.01), while levels of IL-4, IL-10 and PLT were higher than those before treatment, and were higher in the observation group than those in the control group (P<0.05, P<0.01).The total recurrence rate in observation group was significantly lower than that in control group (21.21% vs 48.00%, P<0.05). Conclusion Anti-Hp combined with rhTPO in the treatment of refractory ITP patients can significantly improve clinical efficacy, increase PLT level, regulate Th1/Th2 immune balance, alleviate clinical symptoms and improve prognosis.
keywords: Purpura, thrombocytopenic, idiopathic Anti-Helicobacter pylori Recombinant human thrombopoietin T helper type 1 T helper type 2 B lymphocyte
文章编号： 中图分类号：R554+.6 文献标志码：A
基金项目:
| Author Name | Affiliation |
| ZHOU Ying, ZHOU Li, YUAN Yun | Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, China |
引用文本：
周颖，周莉，袁韵.抗幽门螺旋杆菌联合重组人血小板生成素对难治性特发性血小板减少性紫癜Th1/Th2细胞因子的影响[J].中国临床研究,2020,33(12):1624-1627.
周颖，周莉，袁韵.抗幽门螺旋杆菌联合重组人血小板生成素对难治性特发性血小板减少性紫癜Th1/Th2细胞因子的影响[J].中国临床研究,2020,33(12):1624-1627.