两种激素方案治疗HIV相关免疫性血小板减少症的疗效对比

Comparative Study on Efficacy between Two Glucocorticoid Therapy Plans in the Treatment of HIV Associated Immune Thrombocytopenia

目的对比两种不同激素方案治疗HIV相关免疫性血小板减少症(HIV-ITP)的疗效,以探寻出更适合HIV-ITP患者的方案。方法选择18岁≤年龄<60岁HIV/AIDS合并血小板减少的患者,分别使用大剂量地塞米松或常规剂量泼尼松进行治疗,对比两种方案的有效率、复发率。结果治疗结束时(地塞米松组4天、泼尼松组4周)两组的总体有效率分别为84.62%和91.67%,差异无统计学意义(P>0.05);两组的完全反应率分别为38.46%和33.33%,差异无统计学意义(P>0.05)。治疗后继续随访6个月两组的复发率分别为0%和8.33%,差异无统计学意义(P>0.05)。结论采用大剂量地塞米松治疗HIV-ITP患者的有效率与常规剂量泼尼松相似,但地塞米松治疗时间短,避免了长期应用糖皮质激素可能出现的不良反应,患者服药依从性更好,临床工作中可根据具体情况优先选择。

Objective To compare the efficacy of two different glucocorticoid therapy for HIV associated immune thrombocytopenia(HIV-ITP)and find a better treatment for patients with HIV-ITP.Methods Patients aged from 18 to 60 years-old with thrombocytopenia respectively received high-dose dexamethasone or convention al-dose prednisone,and the efficacy and recurrence rate were compared between two treatments.Results No significant difference was found in the total effective rate,total response rate and recurrence rate between the two treatments.At the end of treatment(dexamethasone 40 mg/d for 4 days and prednisone 1.0mg/kg daily for 4 weeks),The difference in overall effective rates between two groups was not statistically significant(84.62%vs 91.67%,P>0.05).The difference in complete response rates between two groups was not statistically significant(38.46%vs 33.33%,P>0.05).The difference in recurrence rates between two groups after follow-up treatment was not statistically significant(0%vs 8.33%,P>0.05).Conclusion The efficacy of high-dose dexamethasone in treating HIV-ITP patients is similar to that of prednisone.However,due to the short treatment time,dexametha sone avoids the possible adverse reactions caused by long-term use of glucocorticoid,and the medication compli ance of patients is better.Priority selection in clinical treatment can be made according to specific cases.