激素治疗无效的免疫性血小板减少症的治疗方法

Treatment of Hormone Refractory Immune Thrombocytopenia

目的探讨激素治疗无效的免疫性血小板减少症的治疗方法 .方法回顾性分析海南省人民医院2013年2月至2015年2月收治的75例激素治疗无效患者的临床资料,按照治疗方法分为对照组(37例)和观察组(38例),分别给予长春新碱治疗和重组人血小板生成素治疗.观察2组的临床效果,并进行比较.结果经过不同的临床治疗之后,经疗效判定,观察组的治疗总有效率为84.21%,显著高于对照组的64.86%(P<0.05),治疗前,2组患者的血小板计数水平比较,差异无统计学意义(P>0.05);经不同的治疗之后7 d、14 d、21 d,2组患者的血小板计数水平较之本组治疗前均出现显著上升的情况,且治疗之后7 d、14 d、21 d,观察组患者的血小板计数水平均显著高于对照组(P<0.05);观察组治疗过程中不良反应发生率显著低于对照组,(P<0.05).结论对于激素治疗无效的免疫性血小板减少症患者,予以重组人血小板生成素治疗可以获得较之长春新碱治疗更好的临床疗效.

Objective To explore the treatment of hormone refractory immune thrombocytopenia.Methods A retrospective analysis was performed on clinical data of 75 cases of patients with ineffective hormone therapy in our hospital from February 2013 to February 2015, and the patients were divided into control group（ 37 cases）and observation group（ 38 cases） according to treatment methods, and were given treatment of vincristine treatment and recombinant human thrombopoietin, respectively. Clinical effect of the two groups were observed and compared.Results After different treatment, the curative effect, the total efficiency of observation group was 84.21%,significantly higher than 64.86% in the control group, the difference was statistically significant（ P〈0.05）, before treatment, no significant difference was found in the platelet counts of the 2 groups of patients, the difference was not statistically significant（ P〉0.05）. Compared with before treatment, on 7d, 14 d, 21 d after different treatment, the levels of platelet count of patients in 2 groups were significantly increased. And the levels of platelet count of patients in the observation group were significantly higher than those in the control group on 7d, 14 d, 21 d after different treatment（ P〈0.05）. The incidence of adverse reactions in the observation group was significantly lower than that in the control group（ P〈0.05）. Conclusion For hormone refractory immune thrombocytopenic patients, recombinant human thrombopoietin treatment has better clinical efficacy than vincristine treatment.