难治性特发性血小板减少性紫癜56例临床分析

Clinical Analysis on 56 Cases of Idiopathic Thrombocytopenic Purpura

目的探讨难治性特发性血小板减少性紫癜(ITP)的治疗及疗效。方法56例难治性ITP分为4组,达那唑(DNZ)组9例,长春新碱(VCR)组13例,环孢霉素A(CsA)组9例,大剂量丙种球蛋白(HD IVIG)组25例,观察各组的疗效和安全性。结果DNZ组有效率为55.6%,VCR组有效率为53.9%,CsA组有效率为55.6%,HD IVIG组有效率为72%。HD IVIG组起效快,DNZ组、VCR组及CsA组起效较慢。结论难治性ITP治疗可选用DNZ、VCR、CsA和HD IVIG,急诊治疗选用HD IVIG疗效好。

Objective To investigate the effects of different treatments for refractory idiopathic thromboeytopenie purpura（ITP）. Methods 56 patients with refractory ITP were divided into 4 groups, including 9 cases in danazol （DNZ） group, 13 cases in vineristine （VCR） group , 9 eases in eyelosporine-A （CsA） group and 25 eases in high dose intravenous gammaglobulin （HDIVIG） group. The clinical effects and the safety of the 4 groups were compared. Results The effective rate was 55.6% in DNZ group, 53.9% in VCR group, 55.6% in CsA group and 72% in HDIVIG group. The time to produce effect was significantly shorter in HDIVIG group than in DNZ,VCR and CsA groups. Conclusion： DNZ, VCR, CsA and HDIVIC, are effective in the treatment of refractory ITP. The better choice of emergency treatment of refractory ITP is HDIVIG.