大剂量地塞米松联合丙种球蛋白治疗特发性血小板减少性紫癜

Large Dose of Dexamethasone Combined with Gamma Globulin in Treatment of Idiopathic Thrombocytopenic Purpura

目的观察静脉滴注大剂量地塞米松联合丙种球蛋白治疗重症、复发(或难治性)特发性血小板减少性紫癜的疗效和不良反应。方法对36例特发性血小板减少性紫癜患者采用静脉滴注大剂量地塞米松20mg/d,静脉滴注丙种球蛋白0.4g/(kg·d)均连用5d。结果36例患者中3例失访。在33例获得随访患者中显效18例(54.5%),部分缓解10例(30.3%),未缓解7例(21.2%),总有效率达84.8%。结论对于重症、糖皮质激素、免疫抑制剂和脾切除术无效的某些难治性成人特发性血小板减少性紫癜患者,联合大剂量丙种球蛋白、地塞米松静脉滴注不失为一种疗效好、维持时间长、不良反应小、能更快升高血小板的治疗方法,并可反复使用。

Objective To observe the clinical effects of large dose of dexamethasone combined with gamma globulin in treatment of severe, recurrent idiopathic thrombocytopenic parpura and its side effects. Methods Thirty-six patients with idiopathic thrombocytopenic purpura were given with large dose of dexamethasone 20 mg/d combined with gamma globulin 0.4 g/（ kg· d） through intravenous drip for successive five days. Results Thirty-three patients were followed up, there were 18 （54.5%） with marked effect, 10 （ 30.3% ） with partial remission, 7 （ 21.2% ） with non-remission, and the total effects were 84.8%. Conclusions As to severe, refractory idiopathic thrombocytopenie purpura, even there is no effect by Corticosteroid,immunosuppressive agents and Splenectomy, the large dose of dexamethasone com- bined with gamma globulin maybe a good method with good effects and side effects,which maintained for a longer time and increase the numbers of platelets.