大剂量地塞米松联合血小板生成素治疗成人初治重症原发免疫性血小板减少症疗效观察

Effect observation of high dose dexamethasone combined with rhTPO in the treatment of adult patients with severe primary immune thrombocytopenia

目的 探讨大剂量地塞米松联合血小板生成素（rhTPO）治疗成人初治重症原发免疫性血小板减少症（ITP）的临床疗效.方法 选择我院2011年1月至2016年5月收治的82例初治重症ITP患者作为研究对象,随机将其分为观察组与对照组,每组41例.对照组患者予以大剂量地塞米松治疗,观察组患者采用大剂量地塞米松联合rhTPO治疗,比较两组患者的治疗效果及治疗过程中血小板的变化情况.结果 与对照组患者相比,观察组第7、15、30、60 d的总有效率均显著较高,差异有统计学意义（P〈0.05）;观察组第7、15、30、60、90 d的PLT值均显著高于对照组,差异有统计学意义（P〈0.05）.结论 大剂量地塞米松联合rhTPO治疗初治ITP效果显著优于单一使用大剂量地塞米松治疗,且安全性较高,值得临床推广.

Objective To investigate the curative effect of high dose of dexamethasone combined with thrombopoietin （rhT- PO） in the treatment of aduh patients with severe primary immune thrombocytopenia. Methods A total of 82 cases of patients with severe ITP treated in our hospital from January 2011 to May 2016 were selected and randomly divided into observation group and control group, each group with 41 cases. The patients in the control group were treated with high dose dexametha- sone, and the patients in the observation group were treated with large dose of dcxamethasone combined with rhTPO, the treatment effect and the change of platelet between the two groups were compared. Results Compared with the control group, the total effective rate of the observation group after 7, 15, 30, 60 days treatment were significantly higher, the differences were statistically significant （P〈0.05）; the PLT level of the observation group after 7, 15, 30, 60, 90 days treatment were sig- nificantly higher than those of the control group, the differences were statistically significant （P〈0.05）. Conclusion High dose dexamethasone combined with rhTPO in the treatment of ITP is significantly better than the single use of high dose dexam- ethasone treatment, and it has high safety, which is worthy of clinical application.