| 徐露露,黄建尧,蔡露青,马圣宇,李洁茹.艾曲波帕联合硫唑嘌呤治疗RITP的疗效及其作用机制研究[J].,2021,(5):911-914 |
| 艾曲波帕联合硫唑嘌呤治疗RITP的疗效及其作用机制研究 |
| Study on the Efficacy and Mechanism of Eltrombopag Combined with Azathioprine in the Treatment of RITP |
| 投稿时间：2020-06-29 修订日期：2020-07-23 |
| DOI：10.13241/j.cnki.pmb.2021.05.023 |
| 中文关键词: 艾曲波帕 硫唑嘌呤 难治性原发免疫性血小板减少症 |
| 英文关键词: Eltrombopag Azathioprine Refractory idiopathic thrombocytopenic purpura |
| 基金项目:国家自然科学基金项目（81270265） |
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| 中文摘要: |
| 摘要 目的：探究艾曲波帕联合硫唑嘌呤治疗难治性原发免疫性血小板减少症（refractory idiopathic thrombocytopenic purpura，RITP）的效果及其作用机制。方法：选择我院于2016年1月~2020年1月收治的难治性原发免疫性血小板减少症患者61例为研究对象，根据入院顺序经随机数字表法分成两组：对照组和研究组。对照组30例应用硫唑嘌呤治疗，研究组31例应用艾曲波帕联合硫唑嘌呤治疗。对比两组治疗效果、外周血Th 淋巴细胞因子水平、B1 淋巴细胞百分数、氧化应激反应指标。结果：研究组的治疗总有效率90.32 %显著高于对照组（73.33 %，P＜0.05）；治疗前，两组的白介素（interleukin，IL）-2、γ 干扰素（interferon-γ，IFN-γ）、IL-4、IL-5水平对比无显著性差异（P＞0.05）；治疗后，两组的IL-2、IFN-γ水平均降低，IL-4、IL-5水平均升高，且研究组更优（P＜0.05）；治疗前，两组的CD19+ 淋巴细胞百分数、CD5+CD19+ 淋巴细胞百分数对比无显著性差异（P＞0.05）；治疗后，两组的CD19+ 淋巴细胞百分数、CD5+CD19+ 淋巴细胞百分数均比治疗前显著降低，且研究组显著低于对照组（P＜0.05）；治疗前，两组的总抗氧化能力(total antioxidant capacity，TAC) 、超氧化物歧化酶(superoxide dismutase，SOD)、褪黑素(melatonin，MT) 与谷胱甘肽(glutathione，GSH)水平对比无显著性差异（P＞0.05）；治疗后，两组的TAC、SOD、MT、GSH水平均比治疗前显著升高，且研究组显著高于对照组（P＜0.05）。结论：艾曲波帕联合硫唑嘌呤治疗RITP的效果显著，其作用机制可能与改善患者的免疫功能及氧化应激状态有关，该方法值得推荐至临床广泛应用。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect and mechanism of Eltrombopag combined with azathioprine in treatment of refractory idiopathic thrombocytopenic purpura (RITP). Methods: 61 patients with refractory idiopathic thrombocytopenic purpura admitted to our hospital from January 2016 to January 2020 were selected as the research subjects.According to the order of admission, they were divided into two groups according to the random number table method. 30 patients in the control group were treated with azathioprine, and 31 patients in the study group were treated with eztropa combined with azathioprine.The treatment effects, peripheral blood Th lymphocyte factor levels, B1 lymphocyte percentage, and oxidative stress response indexes were compared between the two groups. Results: The total effective rate of treatment in the study group was 90.32 %, which was significantly higher than that in the control group (73.33 %, P <0.05). Before treatment, there was no significant difference in the levels of interleukin (IL) -2, interferon gamma (IFN-γ), IL-4, and IL-5 between the two groups of patients (P>0.05). After treatment, the levels of IL-2 and IFN-γ in the two groups decreased, and the levels of IL-4 and IL-5 increased, and the study group was better (P<0.05). Before treatment, there was no significant difference in CD19+ lymphocyte percentage and CD5+ CD19+ lymphocyte percentage between the two groups (P>0.05). After treatment, the percentage of CD19+ lymphocytes and CD5+ CD19+ lymphocytes in two groups were significantly lower, and the study group was significantly lower than the control group (P<0.05). Before treatment, there was no significant difference in the levels of total antioxidant capacity (TAC), superoxide dismutase (SOD), melatonin (MT) and glutathione (GSH) between the two groups (P>0.05). After treatment, the TAC, SOD, MT, and GSH levels of the two groups were significantly higher, and the study group was significantly higher than the control group (P<0.05). Conclusion: Eltrombopag combined with azathioprine has a significant effect on RITP, and its mechanism may be related to improving the immune function and oxidative stress state of the patient. This method is worthy of recommendation to be widely used in clinic. |
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