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。
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.
作者
周颖
周莉
袁韵
ZHOU Ying;ZHOU Li;YUAN Yun(Department of Hematology,West China Hospital,Sichuan University,Chengdu,Sichuan 610000,China)
出处
《中国临床研究》
CAS
2020年第12期1624-1627,共4页
Chinese Journal of Clinical Research
