摘要
目的探讨重组人白细胞介素-11(rhIL-11)联合标准剂量地塞米松治疗新诊断原发免疫性血小板减少症(PITP)患者的近期疗效及对辅助性T淋巴细胞(Th)1/Th2失衡的影响。方法选取2017年1月至2018年12月在该院就诊的新诊断PITP患者66例,采用随机数字表法将其分为观察组和对照组,每组33例。观察组采用rhIL-11(25~50μg/kg,皮下注射,每天1次)联合标准剂量地塞米松(0.15 mg·kg-1·d-1,静脉滴注)治疗,对照组采用标准剂量地塞米松治疗。比较两组患者临床疗效、血小板计数(PLT)、PLT开始上升时间、PLT≥50×109/L所需时间及外周血白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)、Th1、Th2水平,Th1/Th2细胞比值及不良反应发生率。结果治疗4周后,观察组临床总有效率明显高于对照组(93.94%vs.60.60%,P<0.05)。治疗1、2、3、4周后观察组PLT水平明显高于对照组[(125.29±13.39)×109/L vs.(80.18±3.27)×109/L、(164.58±33.51)×109/L vs.(106.15±27.34)×109/L、(178.18±28.45)×109/L vs.(128.52±31.88)×109/L、(176.06±36.57)×109/L vs.(126.15±45.82)×109/L,P<0.05]。观察组PLT开始上升时间及PLT≥50×109/L所需时间均短于对照组[(4.18±0.63)d vs.(6.24±0.81)d、(5.21±1.09)d vs.(7.25±1.49)d,P<0.05]。治疗4周后,观察组Th1和Th1/Th2水平明显低于对照组[(11.36±2.03)pg/mL vs.(14.22±1.93)pg/mL、(10.67±2.35)%vs.(19.05±2.17)%,P<0.05],而Th2水平明显高于对照组[(1.14±0.23)pg/mL vs.(0.87±0.09)pg/mL,P<0.05];观察组IL-4、IFN-γ水平均明显低于对照组[(7.94±0.83)pg/mL vs.(8.73±0.98)pg/mL、(40.19±5.13)pg/mL vs.(49.35±5.82)pg/mL,P<0.05];观察组与对照组总不良反应发生率比较差异无统计学意义(P>0.05)。结论rhIL-11联合标准剂量地塞米松治疗新诊断PITP患者可提高近期疗效,并快速提升PLT及Th1/Th2细胞水平。
Objective To investigate the short-term effect of recombinant human interleukin-11(rhIL-11)combined with standard dose dexamethasone in treating the patients with newly diagnosed primary immune thrombocytopenia(PITP)and its effect on helper T lymphocytes(Th)1/Th2(Th1/Th2)imbalance.Methods Sixty-six patients with newly diagnosed PITP in this hospital from January 2017 to December 2018 were selected and divided into the observation group(n=33)and control group(n=33)by adopting the random number table method.The observation group adopted the treatment of rhIL-11(25-50μg/kg)by hypodermic injection,once daily,combined with standard dose of dexamethasone(0.15 mg·kg-1·d-1 by intravenous drip,while the control group adopted the treatment of standard dose of dexamethasone.The clinical efficacy,PLT count,PLT start increasing time,required time of PLT≥50×109/L,levels of peripheral blood IL-4,IFN-γ,Th1,Th2,Th1/Th2 cells and adverse reaction rate were compared between the two groups.Results The total clinical effective rate after 4-week treatment in the observation group was significantly higher than that in the control group(93.94%vs.60.60%,P<0.05).After 1,2,3 and 4 weeks of treatment,the PLT level of the observation group was significantly higher than that of the control group[(125.29±13.39)×109/L vs.(80.18±3.27)109/L,(164.58±33.51)×109/L vs.(106.15±27.34)×109/L,(178.18±28.45)×109/L vs.(128.52±31.88)×109/L,(176.06±36.57)×109/L vs.(126.15±45.82)×109/L,P<0.05].The rise time of PLT and the time required for PLT≥50×109/L in the observation group were shorter than those in the control group[(4.18±0.63)d vs.(6.24±0.81)d,(5.21±1.09)d vs.(7.25±1.49)d,(P<0.05)].After 4 weeks treatment,the levels of Th1 and Th1/Th2 in the observation group were significantly lower than those in the control group[(11.36±2.03)pg/mL vs.(14.22±1.93)pg/mL,(10.67±2.35)%vs.(19.05±2.17)%,P<0.05],while Th2 level was significantly higher than that in the control group[(1.14±0.23)pg/mL vs.(0.87±0.09)pg/mL,(P<0.05)].Observation
作者
封蔚莹
罗洪强
李丹
金晶
周炀
洪攀
钟永根
FENG Weiying;LUO Hongqiang;LI Dan;JIN Jing;ZHOU Yang;HONG Pan;ZHONG Yonggen(Department of Hematology,Shaoxing People′s Hospital,Shaoxing,Zhejiang 312000,China)
出处
《重庆医学》
CAS
2020年第9期1455-1459,共5页
Chongqing medicine
基金
浙江省绍兴市公益性技术应用研究项目(2014B70064,2018C30066)
2015年度浙江省医坛新秀培养计划(浙卫发[2015]70号)。
