摘要
目的探讨小剂量利妥昔单抗(LD-RIT)联合重组人血小板生成素(rhTPO)治疗糖皮质激素无效或复发的成人原发免疫性血小板减少症(ITP)的疗效与安全性。方法将36例糖皮质激素治疗无效或复发的成人ITP患者随机均分为两组,分别应用LD-RIT联合rhTPO治疗(试验组)或单用LD-RIT治疗(对照组)。比较两组的起效时间、治疗后14、28和90 d的血小板计数、出血评分、完全反应率以及药物不良反应。结果与对照组相比,试验组起效时间缩短(P<0.05)。治疗后14和28 d,试验组血小板计数和完全反应率高于对照组(P<0.05)。两组治疗后出血评分均较治疗前降低(P<0.05)。两组感染、凝血功能及肝肾功能异常发生率无统计学差异(P>0.05)。结论与单用LD-RIT比较,LD-RIT联合rhTPO治疗糖皮质激素无效或复发的成人ITP,可缩短起效时间,提高血小板水平,减少出血风险,且不良反应轻微。
Objective To evaluate the efficacy and safety of low-dose rituximab(LD-RIT) combined with recombinant human thrombopoietin(rhTPO) in the treatment of corticosteroid-resistant/relapsed adult primary immune thrombocytopenia(ITP).Methods Thirty-six patients with corticosteroid-resistant/relapsed adult ITP were equally and randomly divided into two groups.Group A was treated with LD-RIT combined with rhTPO,while group C was treated with LD-RIT alone.The onset time, platelet count, bleeding score, complete response rate on the 14th,28th and 90th day after treatment and adverse responses were compared between the two groups.Results Compared with group C,the onset time of group A was shorter(P<0.05).On the 14th and 28th day after treatment, the platelet count and complete response rate of group A were higher than those of group C(P<0.05).The bleeding scores of two groups were significantly reduced after treatment(P<0.05).There was no significant difference in the incidence of adverse responses such as infection, abnormal coagulation function and liver and kidney function between the two groups(P<0.05).ConclusionCompared to LD-RIT alone, the combined use of LD-RIT and rhTPO for the treatment of corticosteroid-resistant/relapsed adult ITP can shorten the onset time, improve the platelet level, reduce the risk of bleeding and has mild adverse responses.
作者
马海佳
陈进
陶健
黄泉
王铃
周晓丹
顾喆赟
MA Haijia;CHEN Jin;TAO Jian(Department of Hematology,Second Affiliated Hospital,Nantong University,Nantong 226001,CHINA)
出处
《江苏医药》
CAS
2021年第3期247-250,共4页
Jiangsu Medical Journal
基金
南通市科技项目(MS12017003-3)。
