特发性血小板减少性紫癜治疗方案的选择

The choice of therapy protocol for idiopathic thrombocytopenic purpura

目的:评价特发性血小板减少性紫癜(ITP)治疗方案,选择合理的治疗模式。方法:采用回顾性病例分析,对不同治疗组治疗ITP的有效率、血小板上升速度进行比较。结果:单纯激素治疗组、激素加免疫抑制剂组、激素加丙种球蛋白组、脾切除组的有效率分别为61%、33%、71%、82%。血小板上升至正常的时间分别为9.23±4.65、14.25±5.12、5.50±1.60、2.50±1.91d。激素加丙种球蛋白组、脾切除组的有效率及血小板上升速度均优于另两组,P<0.05(组间比较t检验)。结论:激素加丙种球蛋白应作为ITP治疗首选方案,对于不能用激素维持及减量后复发的病人,应尽早做脾切除。

Objective:To evaluate the protocols of Idiopathic thrombocytopenic purpura (ITP)and choose the best treatment mode.Method Use the retrospective analysis to compare the efficiencies and ascendent rates of platelets.Results the efficiency of the pure corticosteroids treatment group is61%,the corticosteroids plus immunosuppressants group is33%,the corticosteroids plus gamma-globulin group is71%,the splenectomy group is82%.The time for platelets to rise to normal level is9.23±4.65,14.25±5.12,5.50±1.60,2.50±1.91days respectively.The corticosteroids plus immunosuppressants group and the splenectomy group see better results in both the two indexes,P<0.05(t test).Conclusion Our findings suggest that corticosteroids plus gammaglobulin may be the firstly con-siderable treatment of ITP,and the the splenectomy should be executed early for those who can not be maintained with corticos-teroids or relapse when reduce the dose(or both).