分析地塞米松冲击治疗原发免疫性血小板减少症的疗效及对睡眠质量的影响

Analysis of the Therapeutic Effect of Dexamethasone Pulse Therapy on Primary Immune Thrombocytopenia and Its Impact on Sleep Quality

目的:分析地塞米松冲击治疗原发免疫性血小板减少症的疗效及对睡眠质量的影响。方法:选取2022年1月至2023年12月福建省泉州市第一医院收治的原发免疫性血小板减少症患者120例作为研究对象,按照随机数字表法分为对照组和观察组,每组60例。对照组给予传统激素治疗,观察组给予地塞米松冲击治疗,采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,比较2组患者干预后的治疗有效率,并比较2组患者的血小板参数、免疫功能及并发症情况。结果:治疗后,观察组的总有效率显著高于对照组,观察组睡眠质量PSQI评分显著低于对照组,差异均有统计学意义(均P<0.05);观察组免疫功能指标调节性B细胞(Breg)、白细胞分化抗原40配体(CD40L)、白细胞分化抗原4阳性白细胞分化抗原25阳性调节性T细胞(CD4^(+)CD25^(+)Treg)显著高于对照组,白细胞相关免疫球蛋白样受体-1(LAIR-1)显著低于对照组,差异均有统计学意义(均P<0.05);干预后,血小板相关免疫球蛋白G(PAIgG)、血小板相关免疫球蛋白M(PAIgM)显著低于对照组,血小板计数(PLT)显著高于对照组,差异均有统计学意义(均P<0.05);2组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论:ITP患者在地塞米松冲击治疗后会显著改善睡眠质量,疗效显著,能够有效改善血小板参数,且安全性较高,值得临床推广应用。

Objective:To analyze the therapeutic effect of dexamethasone pulse therapy on primary immune thrombocytopenia and its impact on sleep quality.Methods:A total of 120 patients with primary immune thrombocytopenia admitted to the First Hospital of Quanzhou City,Fujian Province from January 2022 to December 2023 were selected as the study subjects.They were randomly divided into a control group and an observation group using a random number table method,with 60 cases in each group.The control group was treated with traditional hormone therapy,while the observation group was treated with dexamethasone shock therapy.The Pittsburgh Sleep Quality Index(PSQI)was used to compare the changes in sleep quality before and after intervention between the two groups of patients,to compare the treatment effectiveness after intervention,and to compare the platelet parameters,immune function,and complications of the two groups of patients.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group,and the PSQI score of sleep quality in the observation group was significantly lower than that of the control group.The difference between the two groups was statistically significant(P<0.05);The immune function indicators of the observation group,including regulatory B cells(Breg),leukocyte differentiation antigen 40 ligand(CD40L),and leukocyte differentiation antigen 4 positive and leukocyte differentiation antigen 25 positive regulatory T cells(CD4^(+)CD25^(+)Treg),were significantly higher than those of the control group.The levels of leukocyte-associated immunoglobulin-like receptor-1(LAIR-1)were significantly lower than those of the control group,and the differences between the two groups were statistically significant(P<0.05);after intervention,platelet-associated immunoglobulin G(PAIgG)and platelet associated immunoglobulin M(PAIgM)were significantly lower than the control group,and platelet count(PLT)was significantly higher than the control group.The differences between the two groups were statistically significant(P<0.05);There was no statistically significant difference in the incidence of complications between the two groups of patients(P>0.05).Conclusion:After dexamethasone shock therapy,ITP patients can significantly improve their sleep quality,have significant therapeutic effects,effectively improve platelet parameters,and have high safety,which is worthy of clinical promotion and application.