大剂量地塞米松联合重组人促血小板生成素治疗重症免疫性血小板减少症疗效分析

Efficacy of high-dose dexamethasone combined with recombinant human thrombopoietin in treatment of severe ITP patients

目的探讨大剂量地塞米松联合重组人促血小板生成素(rhTPO)治疗重症原发免疫性血小板减少症(ITP)的临床疗效,评估对血小板的改善作用和安全性。方法选择2014年5月至2018年4月重症ITP患者62例,随机分为对照组(31例)和研究组(31例),对照组常规治疗,研究组给予大剂量地塞米松联合rhTPO治疗。观察临床疗效、不良反应发生发率,检测血小板(PLT)结果。结果研究组患者治疗后总有效率分别为83.87%(26/31),高于对照组的64.52%(20/31),研究组不良反应发生率为16.13%(5/31),低于对照组的35.48%(11/31),差异有统计学意义(P<0.05);研究组治疗后第7天、第14天和第30天患者PLT分别为(72.68±5.12)、(84.04±5.26)、(94.32±5.71)×10^9/L,均高于对照组的(63.25±4.33)、(77.37±5.18)、(89.41±5.30)×10^9/L,差异具有统计学意义(P<0.05)。结论应用大剂量地塞米松联合rhTPO治疗重症ITP患者,能够短期显著提高临床疗效,上调血小板水平,并具有较高的安全性。

【Objective】To explore the clinical efficacy of high-dose dexamethasone combined with recombinant human thrombopoietin(rhTPO)in the treatment of severe primary immune thrombocytopenia(ITP),and to evaluate the improvement and safety of platelets.【Methods】Sixty-two severe ITP patients admitted to our hospital from May 2014 to April 2018 were selected and randomly divided into the control group(31 cases)and the study group(31 cases).The control group received routine treatment,and the study group received high-dose dexamethasone combined with rhTPO.Clinical efficacy,adverse reactions were observed and PLT results were measured.【Results】The total effective rate of the study group after treatment was 83.87%(26/31),higher than that of the control group[64.52%(20/31)];the incidence of adverse reactions of the study group was 16.13%(5/31),lower than the control group[35.48%(11/31)],and the difference was statistically significant(P<0.05).PLT(×10^9/L)of the study group at the7 th,14 th and 30 th day after treatment were(72.68±5.12)and(84.04±5.26),(94.32±5.71),higher than that of the control group[(63.25±4.33),(77.37±5.18),(89.41±5.30)],and the difference was statistically significant(P<0.05).【Conclusion】High-dose dexamethasone combined with rhTPO in the treatment of patients with severe ITP can significantly improve clinical efficacy in short term,up-regulate platelet levels,and have high safety.