糖皮质激素规律治疗与成人免疫性血小板减少症近期复发的关系

Regularation of glucocorticoid therapy more than six months can effectively reduced the recent recurrence in patients with immune thrombocytopenia

目的:探讨免疫性血小板减少症(ITP)患者糖皮质激素规律治疗与复发率的关系,进一步规范ITP的激素治疗。方法:选取门诊和住院ITP患者共101例,血小板<30×109/L伴出血者予糖皮质激素治疗,按医嘱并逐渐减量组称为常规治疗组,自行停用或随意减量组称为非常规治疗组,比较2组的复发率及复发时间。结果:中位随访时间63个月。非常规治疗组复发率81.8%,显著高于常规治疗组12.9%(P<0.01);其复发相对危险度是正规治疗组的20.7倍;且平均复发时间4.8个月,显著短于常规治疗组44.8个月(P<0.05)。结论:糖皮质激素规律减量治疗6个月以上可明显降低ITP的复发。

Objective：To discuss the relationship between the regular therapy with glucocorticoid and the re- lapse rate in immune thrombocytopenia （ITP）patients,and to further standardize the glucocorficoid treatment of ITP.Methods：One hundred and one patients who were diagnosed as ITP admitted into hospital or outpatients were enrolled in the study,the patients were treated with prednisone when the platelet count was less than 20~30x109/L and absence of bleeding,according to the prescription and gradually reduced prednisone dosage groups known as the regular treatment groups,otherwise,reducded dosage or withdrawal the prednisone ran- domly called unregular treatment groups.Results：There were significant differences of relapse rate between the unregular and regular treatment groups （81.8% vs 12.8%,P〈0.01）,the odd ratio of the relapse was 20.7 times in unregular than regular treatment groups.Also,there were significant differences of average relapse times be- tween the unregular and regular treatment groups （4.8months vs 44.8months,P〈0.05）.Conclusion：Regular of glucocorticoid therapy more than six months can effectively reduced the recent relapse rate in ITP patients.