特发性血小板减少性紫癜治疗方案的选择

Selection of protocol for treatment of idiopathic thrombocytopenic purpura

目的评价特发性血小板减少性紫癜(ITP)治疗方案。方法采用回顾性病例分析,对各组治疗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、脾切除组的有效率分别为75%、41.7%、85%。血小板上升至正常的时间分别为(7.3±3.20)d、(16.01±4.07)d、(2.52±1.48)d。脾切除组的有效率及血小板上升速度优于另两组,P<0.05(组间比较t检验)。结论激素应作为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 for treatment of Idiopathic thrombocytopenie purpura （ITP）, Methods The ITP patients were divided into corticosteroids group, eortieosteroids plus immunosuppressive agents group and splenectomy group. results of treatment of ITP patients were retrospectively analayzed. Results The effective rates in the eortieosteroids group, corticosteroids plus immunosuppressive agents group and splenectomy group 75%, 41.7% and 85%. The time for platelets to increase to normal level were 7.3 ± 3.20,16.01 ± 4.07,2.52 ± 1.48 days respectively. The effective rate and the speed of increase of platelet in splenectomy group were superior to other two groups （ P 〈 0.05）. Conclusion Corticosteroids may be the drug of ftrst consideration for treatment of ITP and the splenectomy be used as early as possible to those cortlcosterolds is no longer effective or or those recurrent after treatmetn with reduced dose of corticosteroids.