艾曲泊帕对原发性免疫性血小板减少性紫癜患者巨核细胞及HPA表达的影响研究

Effect of Eltrombopag on the Expression of Megakaryocytes and HPA in Patients with Primary Immune Thrombocytopenic Purpura

目的探讨艾曲泊帕对原发性免疫性血小板减少性紫癜(immune thrombocytopenia,ITP)患者巨核细胞及人抗血小板特异性抗体(human platelet antigen,HPA)表达的影响。方法方便选取2020年7月—2021年3月包头医学院第一附属医院收治的ITP患者74例为研究对象,依据随机数表法随机分为观察组37例与对照组37例。对照组患者给予重组人血小板生成素治疗,观察组患者给予艾曲泊帕治疗。比较两组治疗效果、血小板计数(platelet count,PLT)、巨核细胞计数、HPA相关抗体及出血评分变化,分析巨核细胞计数、HPA IgG、HPA IgM与PLT的相关性。结果观察组治疗总有效率为91.89%高于对照组的72.97%,差异有统计学意义(χ^(2)=4.573,P<0.05)。两组治疗后PLT水平、巨核细胞计数均较治疗前高,且观察组高于对照组,差异有统计学意义(P<0.05)。两组治疗后HPA IgG、HPA IgM水平、出血评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。PLT与巨核细胞计数呈正相关(r=0.78,P<0.05),与HPA IgG和HPA IgM呈负相关(r=-0.82、-0.71,P<0.05)。结论艾曲泊帕应用于ITP患者的疗效良好,可提高巨核细胞数量及降低HPA相关性抗体表达。

Objective To investigate the effect of itripopa on the expression of megakaryocyte and human platelet specific antibody(HPA)in patients with primary immune thrombocytopenic purpura(ITP).Methods 74 ITP patients admitted to the First Affiliated Hospital of Baotou Medical College from July 2020 to March 2021 were conveniently selected as the study subjects.They were randomly divided into an observation group of 37 cases and a control group of 37 cases using a random number table method.Patients in the control group were treated with recombinant human thrombopoietin,while patients in the observation group were treated with itropril.The therapeutic effect,platelet count(PLT),megakaryocyte count,HPA related antibody and bleeding score were compared between the two groups,and the correlation between megakaryocyte count,HPA IgG,HPA IgM and PLT was analyzed.Results The total effective rate of the observation group was 91.89%,which was higher than that in the control group's 72.97%,the difference was statistically significant(χ^(2)=4.573,P<0.05).The PLT level and megakaryocyte count of the two groups after treatment were higher than those before treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).After treatment,the levels of HPA IgG,HPA IgM,and bleeding scores in both groups were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).PLT was positively correlated with megakaryocyte count(r=0.78),and negatively correlated with HPA IgG and HPA IgM(r=-0.82,-0.71),the difference was statistically significant(P<0.05).Conclusion The efficacy of itripopa in ITP patients is good,which can increase the number of megakaryocyte and reduce the expression of HPA related antibodies.