艾曲泊帕对绝经伴免疫性血小板减少症患者阴道出血和血小板相关参数的影响

doi:10.19829/j.zgfybj.issn.1001-4411.2024.14.004

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题名	艾曲泊帕对绝经伴免疫性血小板减少症患者阴道出血和血小板相关参数的影响
其他题名	Effect of Eltrombopag on vaginal bleeding and platelet-related parameters in postmenopausal patients with immune thrombocytopenia
作者	金珍琳1; 金婷2; 章瑜1; 庄强1
发表日期	2024-07-10
发表期刊	中国妇幼保健影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	免疫性血小板减少症绝经艾曲泊帕阴道出血血小板
其他关键词	Immune thrombocytopenia ; Postmenopausal ; Eltrombopag ; Vaginal bleeding ; Platelets
摘要	目的探讨艾曲泊帕对绝经伴免疫性血小板减少症（ITP）患者阴道出血及血小板相关参数的影响。方法回顾性分析2018年11月—2022年12月温州医科大学附属第一医院收治的86例绝经伴ITP患者的一般资料，依据治疗方法将其分为对照组（47例）和艾曲泊帕组（39例）。对照组施以常规激素治疗，观察组则在此基础上加用艾曲泊帕，两组均连续治疗8周。比较两组临床疗效、治疗前后血小板计数（PLT）、凝血指标、免疫功能指标、阴道出血及不良反应发生率。结果艾曲泊帕组治疗总有效率为94.87%,明显高于对照组的76.59%（t=5.548,P=0.018）;治疗1、2、3、4、8周后，艾曲泊帕组PLT依次为（45.52±6.82）×10～9/L、（63.03±9.45）×10～9/L、（108.27±16.24）×10～9/L、（116.18±17.42）×10～9/L、（120.34±18.05）×10～9/L,均高于对照组的（23.37±3.50）×10～9/L、（34.85±5.22）×10～9/L、（67.16±10.07）×10～9/L、（74.55±11.18）×10～9/L、（83.27±12.49）×10～9/L,差异均有统计学意义（t=19.412、17.491、14.353、13.399、11.216,均P=0.000）;与对照组凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）水平[（15.28±2.29）s、（36.46±5.46）s]相比较，治疗后艾曲泊帕组PT、APTT[（12.43±1.86）s、（32.14±4.82）s]水平较低，差异有统计学意义（t=6.246、3.850,均P=0.000）;治疗后艾曲泊帕组CD3+、CD4+及CD8+水平分别为（64.29±9.64）%、（40.35±6.05）%、（32.18±4.82）%,均高于对照组的（58.44±7.86）%、（36.77±5.51）%、（27.35±4.10）%,差异均有统计学意义（t=3.100、2.869、5.021,P=0.002、0.005、0.000）;治疗后艾曲泊帕组阴道出血4例（10.25%）,明显低于对照组的16例（34.04%）,差异有统计学意义（t=6.756,P=0.009）;艾曲泊帕组和对照组不良反应发生率分别为15.38%、10.63%,两组比较差异无统计学意义（t=0.430,P=0.511）。结论将艾曲泊帕应用于绝经伴ITP患者的治疗当中，临床效果显著，有利于缓解患者阴道出血，提高PLT,同时也能有效改善患者机体凝血功能和免疫功能，且具有较高的安全性。
其他摘要	Objective To investigate the effects of Eltrombopag on vaginal bleeding and platelet-related parameters in postmenopausal patients with immune thrombocytopenia(ITP).Methods The general data of 86 postmenopausal patients with ITP admitted to The First Affiliated Hospital of Wenzhou Medical University from November 2018 to December 2022 were retrospectively analyzed.According to treat-ment methods,they were divided into control group(n=47)and Eltrombopag group(n=39).The control group received conventional hor-mone therapy,and the observation group was additionally treated with Eltrombopag.Both groups were treated continuously for 8 weeks.The clinical efficacy,platelets(PLT)before and after treatment,coagulation index,immune function index,vaginal bleeding and incidence of adverse reactions were compared between the two groups.Results The total effective rate was 94.87％,which was significantly higher than that of the control group(76.59％,t=5.548,P=0.018).After 1,2,3,4,8 weeks of treatment,The PLT of Eltrombopag group was(45.52±6.82)×109/L,(63.03±9.45)×109/L,(108.27±16.24)×109/L,(116.18±17.42)×109/L,(120.34±18.05)×109/L.They were higher than those in the control group(23.37±3.50)×109/L,(34.85±5.22)×109/L,(67.16±10.07)×109/L,(74.55±11.18)×109/L,(83.27±12.49)× 109/L,the differences were all statistically significant(t=19.412,17.491,14.353,13.399,11.216,all P=0.000,);Compared with the control group[(15.28±2.29)s,(36.46±5.46)s],the levels of prothrombin time(PT)and activated partial thromboplastin time(APTT)[(12.43±1.86)s,(32.14±4.82)s]in the Eltrombopag group after treatment were lower,the differences were statistically significant(t=6.246,3.850,all P=0.000).After treatment,the levels of CD3+,CD4+and CD8+were(64.29±9.64)％,(40.35±6.05)％and(32.18±4.82)％,in the Eltrombopag group.Those in the control group were(58.44±7.86)％,(36.77±5.51)％,(27.35±4.10)％,the differences were all statistically significant(t=3.100,2.869,5.021,P=0.002,0.005,0.000).After treatment,vaginal bleeding in 4 cases(10.25％)was significantly lower than that in 16 cases(34.04％)in the control group,the differences were statistically significant(t=6.756,P=0.009).The incidence of adverse reactions was 15.38％and 10.63％in the Eltrombopag group and the control group,respectively,and there was no significant difference between the two groups(t=0.430,P=0.511).Conclusion The application of Eltrombopag in the treatment of postmenopausal patients with ITP has significant clini-cal effect,which is conducive to relieving vaginal bleeding and improving PLT,and can also effectively improve the coagulation function and immune function of patients,with high safety.
资助项目	浙江省温州市基础性医疗卫生科技项目(Y2020548);
ISSN	1001-4411
卷号	39 期号:14 页码:2566-2570
DOI	10.19829/j.zgfybj.issn.1001-4411.2024.14.004
页数	5
收录类别	CNKI ; 万方 ; 维普
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引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/217193
专题	附属第一医院附属第一医院_手术室附属第一医院_血液内科
作者单位	1.温州医科大学附属第一医院血液内科; 2.温州医科大学附属第一医院手术室
第一作者单位	附属第一医院; 血液内科
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	金珍琳,金婷,章瑜,等. 艾曲泊帕对绝经伴免疫性血小板减少症患者阴道出血和血小板相关参数的影响[J]. 中国妇幼保健,2024,39(14):2566-2570.
APA	金珍琳, 金婷, 章瑜, & 庄强. (2024). 艾曲泊帕对绝经伴免疫性血小板减少症患者阴道出血和血小板相关参数的影响. 中国妇幼保健, 39(14), 2566-2570.
MLA	金珍琳,et al."艾曲泊帕对绝经伴免疫性血小板减少症患者阴道出血和血小板相关参数的影响".中国妇幼保健 39.14(2024):2566-2570.