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短周期大剂量地塞米松+小剂量地塞米松维持治疗特发性血小板减少性紫癜的疗效 被引量:7

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摘要 目的:观察短周期大剂量地塞米松+小剂量地塞米松维持治疗特发性血小板减少性紫癜的疗效、不良反应和并发症。方法:地塞米松40mg/d,分2次口服,连用4d,每2周为1个疗程,连用3个疗程。大剂量地塞米松使用间歇期间,22例患者常规采用地塞米松0.035mg/(kg·d)维持治疗(HD-RM组),23例患者仅在血小板≤20×109/L时或患者仍有1级以上出血时采用地塞米松0.035mg/(kg·d)维持治疗(HD-SM组),采用甲泼尼龙冲击并维持治疗的22例患者为对照组(甲泼尼龙组)。结果:(1)HD-RM组3个疗程结束时的有效率高于HD-SM组(81.8%vs65.2%,P<0.05)。(2)HD-RM组3个疗程结束时的有效率与甲泼尼龙组相当(81.8%vs77.2%,P>0.05)。但HD-RM组的不良反应和并发症的发生率及平均住院费用明显低于甲泼尼龙组;(3)HD-RM组和HD-SM组第3个疗程结束时的有效率高于第1和第2个疗程结束时;(4)HD-RM组患者每个疗程结束后的有效率均高于HD-SM组;(5)疗程结束后第1、2、3、4个月HD-RM组患者复发率分别为18.2%、18.2%、27.3%和31.8%,均低于HD-SM组和甲泼尼龙组。结论:短周期3个疗程方案是治疗成人初诊特发性血小板减少性紫癜的有效方法,大剂量地塞米松使用间歇期小剂量地塞米松维持治疗有助于提高患者的远期疗效,同时不良反应和并发症的发生率较小。
出处 《实用医学杂志》 CAS 北大核心 2010年第15期2818-2820,共3页 The Journal of Practical Medicine
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