小牛脾提取物对特发性血小板减少性紫癜患者免疫功能的影响

Effect of Calf Spleen Extract on the Immune Function of Patients with Idiopathic Thrombocytopenic Purpura

目的探讨小牛脾提取物对特发性血小板减少性紫癜(ITP)患者免疫功能的影响。方法选取医院2013年3月至2014年12月收治的ITP患者128例,随机分为对照组和观察组,各64例。对照组患者给予醋酸泼尼松治疗,观察组患者给予醋酸泼尼松联合小牛脾提取物治疗。比较两组患者的临床疗效,观察治疗前后患者的血小板计数(PLT)、血小板比积(PCT)、平均血小板体积(MPV)和血小板分布宽度(PDW),免疫球蛋白(IgG,IgA,IgM)和补体(C3和C4)的变化情况,观察治疗过程中不良反应的发生情况。结果治疗组总有效率为98.44%,明显高于对照组的84.38%(P<0.05);治疗后,两组患者PLT均较治疗前明显升高,且观察组明显高于同期对照组(P<0.05),但两组患者PCT,MPV,PDW指标均较治疗前明显降低,且观察组明显低于同期对照组(P<0.05);两组患者IgG,IgA,C4水平均较治疗前明显升高,且观察组明显高于同期对照组(P<0.05);两组患者IgM和C3水平治疗前后比较,差异无统计学意义(P>0.05);观察组不良发应发生率明显低于对照组(P<0.05)。结论小牛脾提取物可提高糖皮质激素治疗ITP的疗效,增加血小板数量和机体的免疫力,降低糖皮质激素导致的不良反应发生率,值得临床推广。

Objective To investigate the effect of calf spleen extract on the immune function of patients with idiopathic thrombocytopenic purpura. Methods 128 patients with idiopathic thrombocytopenic purpura from March 2013 to December 2014 were randomly divided into the control group and the observation group,64 cases in each group. The control group was given vincristine treatment,and the observation group was treated with vincristine combined with calf spleen extract. The clinical efficacy of the two groups were compared,and the platelet count（ PLT）,platelet ratio（ PCT）,mean platelet volume（ MPV） and platelet distribution width（ PDW）,immunoglobulin（ IgA,IgM and IgG） and complement（ C4 and C3） the patients were recorded before and after treatment. Results After treatment,the total effective rate in the treatment group was 98. 44%,which was significantly higher than 84. 38% in the control group（ P〈0. 05）.The PLT index increased,and the observation group was significantly higher than that of the control group,the difference was statistically significant（ P〈0. 05）. The MPV,PDW and PCT index were decreased in both groups,while the observation group was significantly lower than that of the control group（ P〈0. 05）. The IgA,C4,IgG levels of the two groups were elevated,while the observation group was significantly higher than the same period of the control group（ P〈0. 05）. The levels of IgM and C3 in the two groups were not significantly different before and after treatment（ P〈0. 05）. The incidence rate of adverse reaction in the observation group was significantly lower than the control group（ P〈0. 05）. Conclusion The calf spleen extract can improve the clinical efficiency of glucocorticoid ITP treatment,increase the number of platelets and immunity,decrease the adverse reactions caused by glucocorticoid,which is worthy of clinical promotion.