重组人血小板生成素联合替格瑞洛对老年血小板减少症患者冠脉血流的影响

Effects of recombinant human thrombopoietin combined with ticagrelor on coronary blood flow in elderly patients with thrombocytopenia

目的 探讨重组人血小板生成素联合替格瑞洛对老年血小板减少症患者冠脉血流的影响。方法 选择2018年12月~2021年11月在某院诊治的老年原发性免疫性血小板减少症(primary immune thrombocytopenia,ITP)患者96例,根据随机1∶1分配原则把患者分为联合组与对照组,各48例。对照组给予重组人血小板生成素治疗,联合组给予重组人血小板生成素联合替格瑞洛治疗,两组治疗观察1个月,采用超声测定患者冠脉血流变化情况。结果 治疗后联合组的总有效率为97.9%,高于对照组的83.3%(P<0.05)。两组治疗期间的恶心呕吐、神经感觉异常、白细胞下降、皮肤反应等不良反应发生情况对比差异无统计学意义(P>0.05)。两组治疗后的血清白细胞介素-1β(Interleukin-1β,IL-1β)、IL-6水平低于治疗前(P<0.05),联合组低于对照组(P<0.05)。两组治疗前冠脉血流TIMI分级对比差异无统计学意义(P>0.05),治疗后均优于治疗前(P<0.05),联合组优于对照组(P<0.05)。结论 重组人血小板生成素联合替格瑞洛在老年血小板减少症患者的应用能改善冠脉血流状况,抑制血清IL-1β、IL-6的表达,也能提高治疗效果,减少不良反应的发生。

Objective To investigate the effects of recombinant human thrombopoietin combined with ticagrelor on coronary blood flow in elderly patients with thrombocytopenia.Methods From December 2018 to November 2021,a total of 96 elderly patients with primary immune thrombocytopenia(ITP)who were diagnosed and treated in our hospital were selected,and the patients were divided into the combination group and the control group accorded to the random 1∶1 allocation principle.The control group were treated with recombinant human thrombopoietin,and the combination group were treated with recombinant human thrombopoietin combined with ticagrelor.The two groups were observed for 1 month,and the changes of coronary blood flow were measured by ultrasound.Results After treatment,the total effective rates of the combination group were 97.9%,which were higher than 83.3%of the control group(P<0.05).There were no significant difference in the incidence of adverse reactions such as nausea and vomiting,neuroparesthesia,leukopenia,and skin reaction compared between the two groups during treatment(P>0.05).The serum levels of interleukin-1β(IL-1β)and IL-6 in the two groups after treatment were lower than those before treatment(P<0.05),and the combination group were lower than that in the control group(P<0.05).There were no significant difference in the TIMI grading of coronary blood flow between the two groups before treatment(P>0.05),both groups were better than before treatment at after treatment(P<0.05),and the combination group were better than the control group(P<0.05).Conclusion The application of recombinant human thrombopoietin combined with ticagrelor in elderly patients with thrombocytopenia can improve coronary blood flow,inhibit the expression of serum IL-1βand IL-6,and also improve the therapeutic effect and reduce the incidence of adverse reactions.