小剂量利妥昔单抗联合醋酸泼尼松片治疗原发性免疫性血小板减少症的效果分析

Analysis on the Effect of Low-Dose Rituximab Combined with Prednisone Acetate Tablets in the Treatment of Primary Immune Thrombocytopenia

目的分析小剂量利妥昔单抗联合醋酸泼尼松片治疗原发性免疫性血小板减少症(PITP)的临床效果。方法选取2016年1月至2019年12月我院收治的60例PITP患者,根据治疗方法不同分为对照组(n=29)和观察组(n=31)。除常规治疗外,对照组采用醋酸泼尼松片治疗,观察组采用小剂量利妥昔单抗联合醋酸泼尼松片治疗,比较两组的治疗效果、血小板计数、血小板特异性抗体水平及治疗期间不良反应发生情况。结果观察组治疗总有效率为93.55%,明显高于对照组的72.41%(P<0.05)。治疗后,两组的血小板计数均高于治疗前,抗GPⅡb/Ⅲa抗体、抗GPⅠb/Ⅰx抗体水平均低于治疗前,且观察组的血小板计数高于对照组,抗GPⅡb/Ⅲa抗体、抗GPⅠb/Ⅰx抗体水平低于对照组(P<0.05)。两组患者治疗期间的不良反应发生率(6.45%vs.13.79%)比较差异无统计学意义(P>0.05)。结论小剂量利妥昔单抗联合醋酸泼尼松片治疗PITP效果显著,可有效提升患者的血小板计数,改善其血小板特异性抗体水平,且安全性较高,值得临床推广应用。

Objective To analyze the clinical effect of low-dose rituximab combined with prednisone acetate tablets in the treatment of primary immune thrombocytopenia(PITP).Methods 60 PITP patients admitted to our hospital from January 2016 to December 2019 were selected and divided into control group(n=29)and observation group(n=31)according to different treatment methods.In addition to routine treatment,the control group was treated with prednisone acetate tablets,and the observation group was treated with low-dose rituximab combined with prednisone acetate tablets.The treatment effect,platelet count,platelet specific antibody levels and adverse reactions during treatment were compared between the two groups.Results The total effective rate of treatment in the observation group was 93.55%,significantly higher than 72.41%in the control group(P<0.05).After treatment,the platelet count of the two groups were higher than those before treatment,and the anti-GPⅡb/Ⅲa antibody and anti-GPⅠb/Ⅰx antibody levels were lower than those before treatment(P<0.05);The platelet count of the observation group was higher than that of the control group,and the anti-GPⅡb/Ⅲa antibody and anti-GPⅠb/Ⅰx antibody levels were lower than those of the control group(P<0.05).No statistical difference was found in the incidence of adverse reactions(6.45%vs.13.79%)during treatment between the two groups(P>0.05).Conclusions Low-dose rituximab combined with prednisone acetate tablets has significant effect in the treatment of PITP,can effectively improve the platelet count and platelet specific antibody level of patients,with higher safety,which is worthy of clinical promotion and application.