重组人血小板生成素治疗妊娠期血小板减少症的效果及对白介素、干扰素影响

Effect of recombinant human thrombopoietin for treating pregnant women with thrombocytopenia and its influence on IL-10, IL-17 and IFN-γ

目的:探讨重组人血小板生成素(rhTPO)治疗妊娠期血小板减少症疗效及对白介素-10(IL-10)、IL-17及干扰素-γ(IFN-γ)影响。方法:选取2016年1月-2018年12月本院收治的妊娠期血小板减少症患者100例,随机分为常规组(n=50)和rhTPO组(n=50),选取同期健康孕妇50例为对照组。常规组给予常规治疗和护理干预,rhTPO组在常规组治疗基础上给予重组人血小板生成素治疗,观察疗效和分娩情况;检测治疗前后血清中IL-10、IL-17、IFN-γ、血小板计数及血常规。结果:治疗后rhTPO组血小板数高于常规组(P<0.05),血红蛋白含量和白细胞计数无变化(P>0.05);IFN-γ、IL-17、PF4水平低于常规组,IL-10、TPO水平高于常规组(P<0.05)。3组阴道分娩率和产后出血发生率无差异(P>0.05)。结论:重组人血小板生成素治疗妊娠期血小板减少症能提高血小板水平,改善患者症状,效果更优,安全性较高,母婴结局良好。

Objective:To investigate the efficacy of recombinant human thrombopoietin(rhTPO)for treating pregnant women with thrombocytopenia,and its influence on interleukin-10(IL-10),interleukin-17(IL-17),and interferon-γ(IFN-γ).Methods:100 pregnant women with gestational thrombocytopenia were included and were divided randomly into group A and group B(50 cases in each group)from January 2016 to December 2018,and another 50 healthy pregnant women were selected in group C during the same period.The women in group A were given rhTPO treatment except to routine treatment and nursing intervention,and the women in group B were given routine treatment and nursing intervention.The therapeutic effect and delivery situation of all women were observed.The levels of serum IL-10,IL-17 and IFN-γ,and blood routine of all women were detected before and after treatment.Results:After treatment,the number of platelets of women in group A was significant higher than that of women in group B(P<0.05),but there were no significant different in hemoglobin content and white blood cell count of women between group A and B(P>0.05).The levels of IFN-γand IL-17 of women in group A were significant lower than those of women in group B,but the levels of IL-10 were significant higher than those of women in group B(P<0.05).There were no significant difference in the incidence of vaginal delivery and postpartum hemorrhage among the three groups(P>0.05).Conclusion:rhTPO used for treating pregnant women with thrombocytopenia can increase their platelet level,alleviate their symptoms,improve maternal and infant outcomes,and have better eficacy and safty.