升血小板胶囊结合泼尼松治疗原发免疫性血小板减少症临床观察及对Treg细胞和Th17细胞的影响

Clinical Observation of Ascending Platelets Capsule Combined with Prednisone in Treatment of Primary Immune Thrombocytopenia and Its Effect on Treg and Th17 Cells

目的:分析探讨原发免疫性血小板减少症(ITP)的治疗中采用升血小板胶囊与泼尼松联合用药的临床观察以及对Treg细胞(调节性T细胞)和Th17细胞(辅助性T细胞17)的影响。方法:ITP患者60例,随机分为对照组和观察组各30例,对照组仅给予泼尼松治疗,观察组在泼尼松治疗基础上加用升血小板胶囊,比较两组治疗前后血小板数(Plt)、Treg细胞计数、Th17细胞计数、IL-10(白介素10)含量、IL-17(白介素17)含量。结果:治疗后,观察组治疗效果(96.67%)显著高于对照组(70.00%);观察组血小板数(132±70)×10~9/L、Treg细胞计数(4.54±1.4)%、IL-10含量(29.36±7.48)ng/L明显高于对照组血小板数(90±53)×10~9/L、Treg细胞计数(3.23±0.90)%、IL-10含量(35.64±8.16)ng/L,差异有统计学意义(P<0.05)。但治疗后两组Th17计数、IL-17含量比较差异无统计学意义(P>0.05)。结论:升血小板胶囊与泼尼松联合应用治疗原发免疫性血小板减少症疗效显著,可有效改变Treg含量,调节ITP作用,同时也证实了ITP发生可能与Treg细胞和Th 17细胞的缺陷有关。

Objective: To analyze the clinical observation of the combined use of Ascending Platelet Capsule and prednisone in the treatment of primary immune thrombocytopenia(ITP) and the effect on Treg cells(regulatory T cells) and Th17 cells(auxiliary T cell 17). Methods: Sixty patients with ITP were randomly divided into 30 cases in the control group and the observation group. The control group was treated with prednisone only. The patients in the observation group were treated with prednisone and Ascending Platelets Capsule. The number of platelets(Plt) and Treg cell count, Th17 cell count, IL-10 and IL-17 contents before and after treatment were compared between the two groups. Results: After treatment, the therapeutic effect of the observation group(96.67%) was significantly higher than the control group(70%), and the number of platelets(132±70)×10^9/L, Treg cell count(4.54±1.4)% and IL-10(29.36±7.48)ng/L of the observation group were significantly higher than those of the control group[the number of platelets(90±53)×10^9/L, Treg cell count(3.23±0.90)%, IL-10 content(35.64±8.16) ng/L] and the difference was statistically significant(P<0.05). There was no significant difference in Th17 count or IL-17 content between the two groups after treatment(P>0.05). Conclusion: The combined use of Ascending Platelet Capsule and prednisone is effective in the treatment of primary immunogenic thrombocytopenia. It can effectively change the content of Treg and regulate the effect of ITP. It is also proved that the occurrence of ITP may be related to the defects of Treg cells and Th 17 cells.