rhTPO联合静脉注射免疫球蛋白治疗儿童难治性重型特发性血小板减少性紫癜疗效观察

Therapeutic effects of rhTPO combining intravenous immunoglobulin on children with severe refractory idiopathic thrombocytopenic purpura

目的 评价重组人血小板生成素（rhTPO）联合静脉注射免疫球蛋白治疗儿童难治性ITP的临床疗效。方法对18例儿童难治性重型ITP进行rhTPO联合静脉注射免疫球蛋白治疗,rhTPO给予每次300U/kg,皮下注射,隔日一次,共7次,同时联合静脉注射免疫球蛋白每次5.0g,每周一次共4次,于rhTPO应用的第1天开始应用。结果 18例儿童难治性重型ITP有15例有效,其中6例完全缓解（随访中位时间6个月,有4例呈持续缓解）,9例部分缓解（其中4例维持3~4个月后血小板再次下降至≤20×109/L）,余3例患儿无效或血小板短暂性升高后快速下降至较低值。结论 rhTPO联合静脉注射免疫球蛋白可使部分难治性重型ITP患儿得到缓解,无明显毒副作用,可成为治疗儿童重型难治性ITP的一种方法。

Objective To evaluate the effec of recombinant human thrombopoietin （rhTPO） combining intravenous im- munoglobulin （WIG） on children with severe refractory idiopathic thromboeytopenic purpura （ITP）. Methods 18 chil- dren with severe refractory ITP were given rhTPO Combining WIG. RhTPO （300μ/kg） was injected hypodermically once every other day with 7 times. At the same time that rhTPO was used on the first day, the seven day, the fifteen day and the twenty - first day,WIG （5.0g） was given. Results The treatment was effective on 15 children including 6 cases to- tally relieved and 9 cases partially remitted. The other 3 cases were not affected or showed that platelet （PLT） quantity increased briefly and then decreased quickly to a lower value. As to the 9 cases partially remitted, after 3 ~ 4 months, there were 4 children whose PLT quantity decreased below 20×109/L. As to the 6 cases totally relieved, in follow - up half a year,there were 4 children lastingly relieved. Conclusion RhTPO combining IVIG can relieve most of the chil- dren with severe refractory ITP, has no abviously toxic and adverse effects, and may be used to cure severe refractory ITP.