减低剂量人免疫球蛋白联合重组人促血小板生成素、糖皮质激素治疗原发免疫性血小板减少症临床观察

Clinical Observation on the Treatment of Primary Immune Thrombocytopenia with Reduced Dose Human Immunoglobulin Combined with Recombinant Human Thrombopoietin and Glucocorticoid

目的:评估减低剂量人免疫球蛋白联合重组人促血小板生成素、糖皮质激素治疗原发免疫性血小板减少症的短期疗效。方法:分析2017年1月至2019年9月在该院住院的45例原发免疫性血小板减少症患者的临床资料。随机分为减低剂量人免疫球蛋白[0.2g/(k g·d)]联合促血小板生成素、糖皮质激素组(观察组)和常规剂量人免疫球蛋白[0.4g/(kg·d)]、糖皮质激素组(对照组)。观察2组短期疗效及不良反应。结果:观察组、对照组,治疗第3天血小板计数≥30×10^9/L的患者分别为22.7%vs 30.4%,治疗第5天血小板计数≥30×10^9/L的分别为90.9%vs 95.7%,第15天完全反应率分别为72.7%vs 78.3%,第15天总反应率分别为95.5%vs 91.3%。均无显著差异(P>0.05)。不良反应轻微。结论:减低剂量人免疫球蛋白联合促血小板生成素、糖皮质激素治疗原发免疫性血小板减少症短期疗效肯定,不良反应少,费效比高,值得临床应用。

Objective:To evaluate the short-term efficacy of reduced dose human immunoglobulin combined with recombinant human thrombopoietin and glucocorticoid in the treatment of primary immune thrombocytopenia.Methods:The clinical data of 45 patients with primary immune thrombocytopenia admitted to the hospital from January 2017 to September 2019 were analyzed.They were randomly divided into three groups:reduced dose human immunoglobulin(0.2g/kg·d)combined with thrombopoietin,glucocorticoid group(observation group),conventional dose human immunoglobulin(0.4g/kg·d)and glucocorticoid group(control group).The short-term effect and adverse reactions were observed.Results:In the observation group and the control group,22.7%vs 30.4%patients with platelet count≥30×10^9/L on the third day,90.9%vs 95.7%patients with platelet count≥30×10^9/L on the fifth day,72.7%vs 78.3%patients with complete response on the 15th day,and 95.5%vs 91.3%patients with total response on the 15th day.There was no significant difference(P>0.05).The adverse reactions were mild.Conclusion:The short-term effect of reducing dose of human immunoglobulin combined with thrombopoietin and glucocorticoid in the treatment of primary immune thrombocytopenia is positive,with less adverse reactions and high costeffectiveness ratio,which is worthy of clinical application.