| 摘要: |
| ［摘要］ 目的 探讨大剂量地塞米松联合利妥昔单抗治疗对原发免疫性血小板减少症（ITP）患者CD4+CD25+ Treg细胞的影响。方法 选择ITP患者146例，根据随机数字表法将患者分为对照组(n=51)、地塞米松组(n=47)、联合组(n=48)；另选取健康体检人员40名作为体检组。对照组采用泼尼松治疗，地塞米松组采用地塞米松治疗，联合组采用地塞米松联合利妥昔单抗治疗，测定并比较三组治疗前及体检组的CD4+CD25+ Treg细胞水平，临床治疗前、治疗2周、治疗4周时的CD4+CD25+CD127 Treg细胞水平、临床疗效和复发情况。结果 对照组、地塞米松组、联合组的CD4+CD25+ Treg细胞水平均明显低于体检组，治疗2周、治疗4周时均比治疗前明显增加，但对照组、地塞米松组先升高后降低，联合组则逐渐升高，在治疗4周时明显高于对照组和地塞米松组，联合组疗效优于对照组和地塞米松组(P<0.01)。联合组复发率为22.9%，明显低于对照组和地塞米松组(P<0.01)。结论 大剂量地塞米松联合利妥昔单抗治疗ITP，可有效提高Treg细胞水平，维持长期疗效显著好于泼尼松和单纯的地塞米松，值得临床借鉴推广。 |
| 关键词: 地塞米松 利妥昔单抗 原发免疫性血小板减少 泼尼松 |
| DOI：10.3969/j.issn.1674-3806.2015.12.15 |
| 分类号:R 558+.2 |
| 基金项目: |
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| Effect of large dose of dexamethasone combined with rituximab on CD4+CD25+ Treg cells in patients with primary immune thrombocytopenia |
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CUI Yun-xia
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Department of Blood Transfusion, Zhumadian Central Hospital, Henan 463000, China
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| Abstract: |
| ［Abstract］ Objective To investigate the effect of large dose of dexamethasone combined with rituximab on CD4+CD25+ Treg cells in the patients with primary immune thrombocytopenia.Methods One hundred and forty-six patients with ITP were collected and divided into the control group(n=51), dexamethasone group(n=47) and combination group(n=48). 40 healthy people were taken as the physical examination group. The control group was given prednisone and the dexamethasone group was treated with dexamethasone. The combination group was given dexamethasone combined with rituximab. CD4+CD25+ Treg cells were determined in all groups. The levels of CD4+CD25+ Treg cells were compared among the three groups and the physical examination group before the treatment. The levels of CD4+, CD25+ and CD127 Treg cells were compared among the three groups before the treatment and 2, 4 weeks after the treatment. The curative effect and recurrence were compared among the three groups.Methods The levels of CD4+CD25+ Treg cells in the control group, dexamethasone group and combination group were significantly lower than those in the physical examination group. The above indicators were significantly increased after the treatment of 2 and 4 weeks than those before the treatment. The indicators were increased at first and then decreased in the control group and dexamethasone group, but they were gradually increased in the combination group and were significantly higher than those in the control group and dexamethasone group after the treatment of 4 weeks. The total effective rate of the combination group was significantly higher than that of the control group and dexamethasone group(P<0.01). The recurrence rate of the combination group(22.9%) was significantly lower than that of the control group and the dexamethasone group（P<0.01）.Conclusion Large dose of dexamethasone combined with rituximab can effectively improve the levels of Treg cells, with a satisfactory long-term curative effect. |
| Key words: Dexamethasone Rituximab Primary immune thrombocytopenic Prednisone |
