摘要
目的:回顾性分析糖皮质激素(GCS)联合不同方案治疗免疫性血小板减少症(ITP)的疗效。方法:选取2014年1月~2016年6月皖南医学院第一、第二附属医院收治的重型ITP且治疗方案以GCS为基础用药的患者41例,根据治疗方案分为A组:GCS+静注人免疫球蛋白(IVIG)+重组人血小板生成素(rhTPO),B组:GCS+IVIG,C组:GCS+rh TPO,D组:GCS。观察4组患者血小板水平达到50×10~9/L和(或)100×10~9/L的平均时间和有效率,同时分析各组不良反应发生情况。结果:A、B、C组患者较之D组具有较高的完全反应(CR)率(P<0.05),A组患者较之B、C、D组患者具有更短的反应时间(TTR)(P<0.05),B、C两组患者TTR差异无统计学意义(P>0.05),但均短于D组(P<0.05)。4组不良反应发生率差异无统计学意义。结论:对接受GCS+IVIG+rh TPO方案的重型ITP患者,其血小板水平具有较高CR率和最短的TTR,未见明显增多不良反应,可依据最新指南共识规范应用。
Objective:To review the effect of glucocorticoid combined with different regimens in the treatment of immune thrombocytopenia(ITP).Methods:Forty-one patients with severe ITP treated in the first and the second affiliated hospital of Wannan Medical College with glucocorticoid were enrolled from January 2014 to June 2016,and divided into 4 groups as the treatment regimen,namely:group A:glucocorticoid+IVIG+rhTPO;group B:glucocorticoid+IVIG;group C:glucocorticoid+rhTPO;group D:glucocorticoid.The four groups were observed regarding the mean time of platelet count reacting 50×10 9/L and/or 100×10 9/L,response rate and incidences of adverse effects.Results:Patients in group A,B and C had a higher rate of complete response(CR)than those in group D(P<0.05),and patients in group A had shorter time to response(TTR)in the four groups(P<0.05).TTR remained no significant difference between group B and C(P>0.05),yet was shorter than group D(P<0.05).The incidence of adverse reactions was not statistically significant among four groups.Conclusion:Patients with severe ITP received glucocorticoid+IVIG+rhTPO regimen had higher CR and the shortest TTR at the platelet level,and no significant adverse effects were observed,which could be used according to the latest guideline and consensus.
作者
顾俊菲
孙薇
张毅
徐静
黄来全
GU Junfei;SUN Wei;ZHANG Yi;XU Jing;HUANG Laiquan(Department of Hematology and Oncology,The Second Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)
出处
《皖南医学院学报》
CAS
2018年第2期120-123,共4页
Journal of Wannan Medical College
基金
安徽省高校自然科学研究项目(KJ2017A263)
