艾曲波帕治疗激素治疗无效或激素依赖性儿童免疫性血小板减少症疗效观察

Effect of eltrombopag in the treatment of hormone therapy ineffective or hormone dependent immune thrombocytopenia in children

目的探讨艾曲波帕治疗激素治疗无效或激素依赖性儿童免疫性血小板减少症(ITP)的临床效果。方法选择2018年2月至2019年6月新乡市中心医院收治的30例激素治疗无效或激素依赖性ITP患儿为研究对象,根据治疗方法将患儿分为观察组和对照组,每组15例。对照组患儿给予静脉注射用人丙种球蛋白治疗,观察组患儿给予艾曲波帕治疗,2组患儿均连续治疗6个月。观察2组患儿治疗1、2、3、4、5、6个月时血小板计数(BPC),分别于治疗1、2、4、6个月评估2组患儿临床疗效,并观察治疗期间2组患儿不良反应发生情况。结果2组患儿治疗前BPC比较差异无统计学意义(P>0.05);2组患儿治疗1、2、3、4、5、6个月BPC均显著高于治疗前(P<0.05),且随着治疗时间延长,BPC呈逐渐升高趋势;治疗1、2、3、4、5、6个月,观察组患儿BPC均显著高于对照组(P<0.05)。治疗1、2、4、6个月,观察组患儿治疗总有效率分别为53.33%(8/15)、66.67%(10/15)、80.00%(12/15)、86.67%(13/15),对照组患儿治疗总有效率分别为33.33%(5/15)、46.67%(7/15)、60.00%(9/15)、73.33%(11/15),观察组患儿治疗总有效率显著高于对照组(P<0.05),且随着治疗时间延长,2组患儿总有效率呈逐渐升高趋势。观察组患儿胃肠道反应、肝功能异常及肾功能异常的发生率分别为20.00%(3/15)、20.00%(3/15)、13.33%(2/15),对照组患儿胃肠道反应、肝功能异常及肾功能异常的发生率分别为13.33%(2/15)、6.00%(1/15)、6.00%(1/15);观察组患儿胃肠道反应、肝功能异常、肾功能异常的发生率显著高于对照组(P<0.05)。2组患儿的胃肠道反应、肝功能异常、肾功能异常均比较轻微,经对症处理后恢复正常,不影响治疗。结论艾曲波帕治疗激素治疗无效或激素依赖性儿童ITP疗效确切,患者耐受良好。

Objective To investigate the clinical effect of eltrombopag in the treatment of hormone therapy ineffective or hormone dependent immune thrombocytopenia(ITP)in children.Methods Thirty children with hormone therapy ineffective or hormone dependent ITP admitted to Xinxiang Central Hospital from February 2018 to June 2019 were selected as the research subjects,and the children were divided into observation group and control group according to the treatment methods,with fifteen cases in each group.The children in the control group were treated with human gamma globulin for intravenous injection,while the children in the observation group were treated with eltrombopag,all children were treated for six months.The blood platelet count(BPC)of the children in the two groups was observed at 1,2,3,4,5 and 6 months of treatment.The clinical effect of the children in the two groups was evaluated at 1,2,4 and 6 months of treatment,and the adverse reactions of the children in the two groups were observed.Results There was no significant difference in BPC between the two groups before treatment(P>0.05).The BPC of the children in the two groups at 1,2,3,4,5 and 6 months of treatment was significantly higher than that before treatment(P<0.05).With the prolongation of treatment time,the BPC gradually increased.At 1,2,3,4,5 and 6 months of treatment,the BPC of children in the observation group was significantly higher than that in the control group(P<0.05).At 1,2,4 and 6 months of treatment,the total effective rate in the observation group was 53.33%(8/15),66.67%(10/15),80.00%(12/15)and 86.67%(13/15),respectively;while the total effective rate in the control group was 33.33%(5/15),46.67%(7/15),60.00%(9/15)and 73.33%(11/15),respectively;the total effective rate in the observation group was significantly higher than that in the control group(P<0.05),and with the prolongation of treatment time,the total effective rate increased gradually.The incidence of gastrointestinal reaction,liver function abnormality and renal function abnormality in the observation group was 20.00%(3/15),20.00%(3/15)and 13.33%(2/15),respectively.The incidence of gastrointestinal reaction,liver function abnormality and renal function abnormality in the control group was 13.33%(2/15),6.00%(1/15)and 6.00%(1/15),respectively.The incidence of gastrointestinal reaction,liver function abnormality and renal function abnormality in the observation group was significantly higher than that in the control group(P<0.05).The gastrointestinal reaction,liver function abnormality and renal function abnormality of the children in the two groups were mild,and the adverse reactions returned to normal after symptomatic treatment and did not affect the treatment.Conclusion Eltrombopag is effective and well tolerated in the treatment of children with hormone therapy ineffective or hormone dependent ITP.