糖皮质激素联合小剂量利妥昔单抗注射液治疗难治性原发性免疫性血小板减少症的效果

Effect of Glucocorticoid combined with low-dose Rituximab Injection in the treatment of refractory primary immune thrombocytopenia

目的探讨糖皮质激素联合小剂量利妥昔单抗注射液治疗难治性原发性免疫性血小板减少症的效果。方法选取2014年1月~2018年1月我院收治的60例难治原发性免疫性血小板减少症患者作为研究对象,根据随机数字表法将患者分为实验组与对照组,每组各30例。对照组患者给予糖皮质激素药物治疗,实验组患者给予糖皮质激素联合小剂量利妥昔单抗注射液治疗,比较两组患者的血小板计数、不良反应总发生率、治疗效果及Th2与Th1的改善情况。结果实验组患者治疗后的血小板计数与Th2水平高于对照组,Th1水平低于对照组,差异有统计学意义(P<0.05);实验组患者的不良反应总发生率低于对照组,差异有统计学意义(P<0.05);实验组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论与单一用药相比,给予难治性原发性免疫性血小板减少症患者糖皮质激素联合小剂量利妥昔单抗注射液治疗不仅有利于提升血小板计数及改善T细胞水平,更利于降低不良反应发生率,具有独特的优势,值得临床进一步推广应用。

Objective To explore the effect of Glucocorticoid combined with low-dose Rituximab Injection in the treatment of refractory primary immune thrombocytopenia.Methods A total of 60 patients with refractory primary immune thrombocytopenia treated in our hospital from January 2014 to January 2018 were selected as the study subjects.According to the random number table method,the patients were divided into experimental group and control group,with 30 cases in each group.The control group was treated with Glucocorticoid.The experimental group was treated with Glucocorticoid combined with low-dose Rituximab Injection.The platelet count,the total incidence of adverse reactions,the therapeutic effect,the improvement of Th2 and Th1 in the two groups were observed.Results After treatment,the platelet count and Th2 level in the experimental group were higher than those in the control group,and the Th1 level was lower than that in the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the experimental group was lower than that in the control group,the difference was statistically significant(P<0.05).The total effective rate in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Compared with single drug,Glucocorticoid combined with low-dose Rituximab Injection treatment for refractory primary immune thrombocytopenia can not only improve platelet count and T cell level,but also reduce the incidence of adverse reactions.It has unique advantages and is worthy of further clinical application.