两种剂量丙种球蛋白联合地塞米松治疗36例重症特发性血小板减少性紫癜患者疗效观察

Therapeutic effects of two-dose immunoglobulin combined dexameth-asone on severe Idiopathic thrombocytopenic purpura(ITP)

目的观察不同剂量静脉滴注丙种球蛋白治疗重症特发性血小板减少性紫癜(ITP)的近期疗效。方法36例重症ITP患者分为两组,分别用静脉滴注丙种球蛋白大剂量400mg/kg·d-1,中剂量200mg/kg·d-1,静脉滴注5d。联合地塞米松10mg/d。观察临床出血症状及血小板计数的变化。结果两组患者近期有效率相近,治疗后出血症状控制时间,血小板开始上升时间,升至≥50×109/L时间,达到峰值的时间和血小板计数峰值,无显著性差异(P>0.05)。结论两种剂量静脉滴注丙种球蛋白联合地塞米松疗效基本相似,中剂量丙种球蛋白相对安全并明显降低医疗费用。

Objective To observe the efectiveness of two dose immunoglobulin combined dexamethasone in the treatment of severe idiopathic thrombocytopenic purura （ITP） .Methods 36 patients hospitalized with severe ITP were divided into two groups （18 cases and 14 cases） , respectively high dose and medium dose intravenous Immunoglobulin 0.4g/ kg .d^-1 and 0.2g/kg. d^-1 for 5 days. Meanwhile,the two groups were injected dexamethasone 10mg/d. gradually reduced the dose while the platelet count upto normal or close to normal. Results There was no significant difference in short-term effective rate between two groups （P〉0.05）,so did the times of blood platelet count （BPC） ascending to peak and various hemorrhagic symptoms controlled, and the rates of starting ascent and BPC peak. Conclusions The efectiveness of two dose immunoglobulin combined dexamethasone were similitude in the treatment of severe ITP,The medium dose Immunoglobulin was more safety than high dose,and obviously reduce the cost of medical treatment.