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The Characteristics of B Cell Activating Factor of the TNF Family in Patients of Idiopathic Thrombocytopenic Purpura and Clinical Observation of High-dose Dexamethasone Treatment in ITP Patients

Author: CuiWenZuo
Tutor: HuangRuiBin
School: Nanchang University
Course: Internal Medicine
Keywords: High-dose Dexamethasone Immunity Thrombocytopenia Purpura B-cell activating factor
CLC: R554.6
Type: Master's thesis
Year: 2011
Downloads: 18
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Abstract


Objective: This study was to detect the mRNA and protein levels of B-cell activating factor (B cell activating factor of the TNF family, BAFF), to study the expression characteristics in patients with ITP, combined with BAFF and platelet count on high-dose dexamethasone Clinical observation on the treatment of ITP ITP difference in efficacy analysis of high-dose dexamethasone with standard-dose hormone therapy, to provide more evidence for further research and to explore the pathogenesis of ITP, Evaluation and prognosis. Methods: The experimental groups experimental group 1 (high-dose dexamethasone treatment) 24 ITP patients in the experimental group (standard-dose hormone therapy) in 22 cases of ITP patients and healthy control group 20 cases (both healthy volunteers), the experimental group 3 (for other reasons thrombocytopenia group) 10 cases. Quantitative PCR and ELISA detection of different treatment options ITP group before and after treatment and healthy control group, the thrombocytopenia group of other reasons BAFF expression. Results: 1 ITP patients before and after treatment and other experimental group BAFFmRNA and protein expression ① ITP patients BAFFmRNA expression level: 46 cases of ITP patients treatment before BAFFmRNA level of 4.94 ± 0.89, 2.88 ± 0.66 after treatment; 20 cases of healthy control group BAFFmRNA level 2.91 ± 0.66; 10 cases of other reasons platelet reduce group BAFFmRNA level was 4.81 ± 0.78. ITP patients after treatment the former BAFFmRNA significantly higher than the level of treatment (P lt; 0.01), pre-treatment levels of BAFF with other causes of thrombocytopenia group had no significant difference (P gt; 0.05) after treatment expression of BAFFmRNA level decreased significantly (P lt; 0.05) after treatment with the healthy control group, no significant difference. 2 ITP patients BAFF protein levels: 46 ITP patients before treatment BAFF protein expression to 721.03 ± 117.70pg/ml.; The treatment after (548.57 ± 88.33pg/ml); 20 healthy control subjects BAFF protein (512.50 ± 86.91pg/ml); 10 cases of other reasons thrombocytopenia group BAFF protein level of 782.00 ± 138.08pg/ml. ITP patients was significantly higher than pre-treatment levels of BAFF treatment (P lt; 0.01), pre-treatment BAFF protein levels with other causes of thrombocytopenia group was no significant difference (P gt; 0.05) after treatment with the healthy control group, no significant difference BAFF expression after treatment decreased significantly (P lt; 0.05). 2, high-dose dexamethasone BAFF expression before and after treatment (1) BAFF mRNA expression of high-dose dexamethasone group and the healthy control group: 24 patients received high-dose dexamethasone treatment of patients treatment of former BAFFmRNA level was 5.06 ± 0.80 after treatment 2.91 ± 0.66 to 2.83 ± 0.79; 20 cases the healthy controls BAFFmRNA level. Agitated treatment of patients receiving high-dose dexamethasone treatment before BAFFmRNA levels were significantly higher than those in healthy control group after treatment, no significant difference with the healthy control group, BAFF expression after treatment decreased significantly (P lt; 0.05) Patients and healthy control group BAFF protein expression (2) high-dose dexamethasone group: 24 patients receiving high-dose dexamethasone treatment in patients with pre-treatment BAFF protein was 695.19 ± 107.55pg/ml, treatment after (538.25 ± 93.43pg/ml), 20 healthy controls were BAFF protein was 512.50 ± 86.91pg/ml. BAFF protein receiving high-dose dexamethasone group before treatment was significantly higher than the healthy control group, no significant difference after treatment with the healthy control group, BAFF protein expression was significantly decreased (P lt; 0.05) after treatment. 3, the standard-dose HT group of patients before and after treatment BAFF expression of to ① the standard dose hormone group and the healthy control group BAFFmRNA expression: 22 patients receiving standard-dose hormone treatment of patients treatment before BAFFmRNA expression to 4.82 ± 0.98 after treatment was 2.93 ± 0.50. Standard-dose hormone therapy the patients before BAFFmRNA levels were significantly higher than those in healthy control group, no significant difference with the healthy control group after treatment, after treatment BAFFmRNA expression decreased significantly (P lt; 0.05). (2) standard-dose hormone group patients and healthy control group BAFF protein expression: 22 patients received standard-dose hormone therapy in patients with pre-treatment BAFF protein 749.22 ± 124.18pg/ml treatment was 559.83 ± 83.08pg/ml. The standard dose hormone therapy in patients with pre-treatment BAFF protein expression was significantly higher than the healthy control group, no significant difference after treatment with the healthy control group, BAFF expression after treatment decreased significantly (P lt; 0.05) (3) detection of patients received standard-dose hormone therapy in patients with previously untreated ITP 1,7,14,21,28 days BAFF protein the nRNA expression, two detection methods are prompted to the BAFF expression gradually decreased, the 28th day BAFF expression and health The control group had no significant difference before treatment and other reasons thrombocytopenia group no significant difference (P gt; 0.05). 4, receiving high-dose dexamethasone treatment of patients and accepts standard-dose hormone therapy in patients with BAFF expression before and after treatment, no significant difference (P GT; 0.05) 5, two experimental groups BAFFmRNA and protein expression and platelet count, there was no significant correlation. Conclusion: 1.BAFFmRNA, and protein expression was significantly higher in the patients with ITP, decreased after treatment with disease activity. Blocking the ITP in high expression of BAFF may become a new target for a treatment of ITP. High-dose dexamethasone treatment of ITP has a high reactivity, side effects and other characteristics, no significant difference in BAFF expression and platelet count with standard-dose hormone therapy program.

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CLC: > Medicine, health > Internal Medicine > Blood and lymphatic system diseases > Blood diseases > Hemorrhagic disease > Purpura
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