不同方案对原发免疫性血小板减少症患者外周血调节T细胞水平变化的影响

摘要

Objective To study the effects of different programs on the level of T cells in peripheral blood of patients with primary immune thrombocytopenia.Methods 88 cases of primary immune thrombocytopenia in our hospital from April 2012 to June 2016 were selected, they were randomly divided into observation group (n=35), control group I (n=26) and control group II (n=27). The observation group was treated with dexamethasone and low-dose ritux infliximab therapy, the control group I was given dexamethasone treatment, the control group II received prednisone, while 30 volunteers in our hospital were selected as Vacuity contrast group. The total effective rate and the peripheral blood T cell level at different time points were compared between the two groups.Results The total effective rate of the observation group was 77.14% (27/35), and the total effective rate was 61.54% (16/26) in the control group I, the total effective rate of II in control group was 62.96% (17/27), the total effective rate of observation group was higher than that of control group II and control group I, the difference was statistically signiifcant (P < 0.05); The level of regulatory T cells in the thirteenth day and twenty-seventh day treatment group was signiifcantly higher than that in control group II and control group I, and the difference was statistically signiifcant (P < 0.05);There was no signiifcant difference (P> 0.05) in the treatment of thirteenth days and twenty-seventh days in the observation group.Conclusion The combination of dexamethasone and small dose of rituximab in the treatment of primary immune thrombocytopenia can improve the proportion of peripheral blood T cells, and has high practical value.%目的：研究不同方案对原发免疫性血小板减少症患者外周血调节T细胞水平变化的影响。方法选取2012年4月～2016年6月收治的88例原发免疫性血小板减少症患者，随机分为观察组（n=35）、对照组I（n=26）和对照组II（n=27），观察组给予地塞米松和小剂量利妥昔单抗治疗，对照组I给予地塞米松治疗，对照组II给予泼尼松治疗，另选取同期于进行健康体检的志愿者30例作为空白对照组，比较研究对象总有效率和不同时间点外周血调节T细胞水平。结果观察组总有效率为77.14%（27/35），对照组I总有效率为61.54%（16/26），对照组II总有效率为62.96%（17/27），观察组总有效率高于对照组I和对照组II，差异均具有统计学意义（P＜0.05）；治疗第13天、第27天，观察组调节性T细胞水平高于对照组I和对照组II，差异均具有统计学意义（P＜0.05）；治疗第13天、第27天，观察组调节性T细胞水平与空白对照组相比，差异无统计学意义（P＞0.05）。结论地塞米松和小剂量利妥昔单抗联合应用于原发免疫性血小板减少症的治疗，可提高患者外周血调节T细胞比例，具有较高的实用价值。