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Received:May 10, 2020 Published Online:December 20, 2020
Received:May 10, 2020 Published Online:December 20, 2020
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 |
Author Name | Affiliation |
ZHOU Ying, ZHOU Li, YUAN Yun | Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, China |
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