rhTPO联合大剂量地塞米松治疗原发性血小板减少症的短中期疗效观察

Short-and medium-term efficacy of rhTPO combined with high-dose dexamethasone in the treatment of primary thrombocytopenia

目的探讨重组人血小板生成素(rhTPO)联合大剂量地塞米松治疗原发性血小板减少症(ITP)的短中期疗效。方法选取我院2014年3月至2017年3月收治的90例ITP患者,根据随机数字表法分成观察组与对照组,各45例。对照组单纯采用大剂量地塞米松治疗,观察组在对照组基础上加用rhTPO,两组均观察3个月。比较两组治疗后1、3个月的临床疗效,记录两组血小板峰值、平均起效时间,分别在治疗前及治疗后1、3个月采血检测两组血小板计数、白细胞计数、血红蛋白水平,并观察不良反应发生率。结果观察组治疗后1、3个月的总有效率分别为82.22%、73.33%,均高于对照组的62.22%、51.11%,差异有统计学意义(P<0.05)。观察组血小板峰值高于对照组,平均起效时间短于对照组,差异有统计学意义(P<0.05)。两组治疗后1、3个月的血小板计数均高于治疗前,且治疗后1个月的血小板计数高于治疗后3个月,观察组治疗后1、3个月的血小板计数高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为17.78%,对照组为13.33%,两组比较差异无统计学意义(P>0.05)。结论 ITP患者采用rhTPO联合大剂量地塞米松治疗,能缩短药物起效时间,提高短中期疗效,进一步改善血小板计数,未增加不良反应发生风险。

Objective To investigate the short-term and medium-term efficacy of recombinant human thrombopoietin(rhTPO)combined with high-dose dexamethasone in the treatment of primary thrombocytopenia(ITP).Methods Ninety patients with ITP admitted to our hospital from March 2014 to March 2017 were randomly divided into observation group and control group,with 45 cases in each group.Control group was treated with high-dose dexamethasone alone,while observation group was treated with rhTPO besides the treatment for control group.Both groups were observed for 3 months.The clinical effects of the two groups were compared respectively at 1 and 3 months after treatment.The platelet peak value and mean onset time were recorded.The platelet count,white blood cell count and hemoglobin level were measured before treatment and 1 month and 3 months after treatment,and the incidence of adverse reactions was observed.Results The total effective rate of observation group was 82.22% and 73.33% respectively after 1 and 3 months of treatment,which was higher than 62.22% and 51.11% of control group,the difference being statistically significant(P<0.05).The peak value of platelet in observation group was higher than that in control group,and the average onset time was shorter than that in control group,the difference being statistically significant(P<0.05).The platelet counts of the two groups at 1 and 3 months after treatment were higher than those before treatment,the platelet counts at 1 month after treatment were higher than those at 3 months after treatment,and the platelet counts at 1 and 3 months after treatment in observation group were higher than those in control group,the difference being statistically significant(P<0.05).The incidence of adverse reactions in observation group was 17.78%,which was not significantly higher than 13.33% in control group(P>0.05).Conclusion The combination of rhTPO and high-dose dexamethasone can shorten the onset time,improve the short-term and medium-term efficacy,and further improve the platelet count in ITP patients without increasing the risk of adverse reactions.