吗替麦考酚酯胶囊治疗原发性免疫性血小板减少症的临床研究

Clinical Observation of Mycophenolate Mofetil Capsules in the Treatment of Primary Immune Thrombocytopenia

目的：观察吗替麦考酚酯胶囊治疗原发性免疫性血小板减少症的临床疗效及不良反应。方法：对某院血液科2011年12月-2013年2月收治的20例原发性免疫性血小板减少症患者使用吗替麦考酚酯胶囊（500 mg,q12h）治疗,观察其疗效及相关不良反应。结果：20例患者中14例（14/20,70%）患者在治疗2~8周后血小板回升,出血症状好转,但仅有1例患者血小板恢复至正常,其余患者血小板维持在41×109~81×109L-1之间。14例血小板回升的患者在口服吗替麦考酚酯胶囊8周后开始减量,其中有6例患者分别在开始将吗替麦考酚酯胶囊减量2~6周后血小板进行性下降,并低于20×109L-1时,换用其他药物治疗;另外8例患者在减量过程中血小板能维持在35×109~68×109L-1之间。20例患者中有6例（6/20,30%）患者使用吗替麦考酚酯胶囊治疗8周后血小板未恢复,仍低于20×109L-1,换用其他药物治疗。20例患者的总有效率为70%,未见明显的不良反应。结果：吗替麦考酚酯胶囊治疗原发性免疫性血小板减少症安全有效。

OBJECTIVE： To observe clinical efficacy and adverse drug reaction of Mycophenolaie mofetil （MMF） capsules in the treatment of primary immune thrombocytopenia. METHODS： 20 patients with primary immtme thrombocytopenia from Dec. 2011 to Feb. 2013 were treated with MMF capsules （500 rag, ql2h） in department of hematology of a hospital. Therapeutic effica- cy and adverse drug reaction were observed. RESULTS： In 14 patients among 20, blood platelet rose again and haemorrhage symp- tom was relieved after 2-8 weeks （ i4/20, 70% ）, all the patients＇ blood platelet maintained at 41 × 109-81 × 109 L-1, excepted for 1 paitent （recoverd to normal）. The drug dosage of the 14 patients whose blood platelet rose again was decreased after 8 weeks of oral administration of MMF capsules, among which the blood platelet of 6 patients was decreased progressively and lower than 20x 109 L-~ 2-6 weeks after decreasing the dose of MMF casuples, and then other drug replaced the therapy. The blood platelet of other 8 patients maintained at 35× 109-68×109 L-1 during decreasing the drug dosage. Among 20 patients, the blood platelet of 6 patients who received MMF capsules for 8 weeks didn＇t returned to normal but lower than 20× 109 L-1, and then other drug replaced the therapy （6/20,30%）. Total effective rate was 70%. No serious adverse drug reaction was observed. CONCLUSIONS： It is safe and effective for MMF capsules in the treatment of primary immune thrombocytopenia.