摘要
目的：探讨特发性血小板减少性紫癜（ＩＴＰ）患者糖皮质激素（ＧＣ）及其受体（ＧＣＲ）改变的临床意义。方法：采用放射免疫分析法和放射性配基多点饱和结合法检测了 ４３例 ＩＴＰ患者和 １５名正常人ＡＣＴＨ、ＧＣ及淋巴细胞表面ＧＣＲ位点水平，对比了单用甲泼尼龙冲击治疗和泼尼松联合环孢素治疗难治性ＩＴＰ的治疗效果。结果：敏感组、中度敏感组ＩＴＰ在ＡＣＴＨ、ＧＣ、ＧＣＲ位点水平与正常人组比较均无显著差异。难治性组患者 ＡＣＴＨ、 ＧＣ的水平明显高于敏感组，而 ＧＣＲ位点却低于敏感组。在治疗难治性 ＩＴＰ方面，泼尼松联合环孢素治疗优于单用甲泼尼龙冲击治疗。结论：ＩＴＰ治疗效果差可能与ＧＣＲ位点减少有关，临床上应用泼尼松的基础上可联合环孢素以提高其疗效。
Objective: To investigate the alteration and significance of glucocorticoid (GC) and glucocorticoid receptor (GCR) in idiopathic thrombocytopenic purpura (YFP). Methods: Levels of ACTH, and GC were measured by radioimmunoassay and GCR was measured by radioligand-binding assay in 15 normal people and 43 ITP patients. Efficacy of methylprednisolone alone or prednisone plus cyclosporin was compared. Results: No significant difference on ACTH, GC and GCR was found among the sensitive, medium-sensitive and control group. ACTH and GC were higher in refractory ITP group than those of sensitive group, but the numbers of glucocorticoid receptor sites was lower. Prednisone plus cyclosporin achieved better remission than high-dose methylprednisolone alone. Conclusion: The poor response of refractory ITP is mainly related to decrease of GCR. Combination of cyclosporin and prednison may improve response rate of refractory ITP.
出处
《新医学》
2000年第4期206-207,共2页
Journal of New Medicine
关键词
血小板减少性紫癜
糖皮质激素
ITP
受体
环孢素
Idiopathic thrombocytopenic purpura Glucocorticoid Receptor Cyclosporin Methylprednisolon
