期刊文献+

霉酚酸酯治疗激素无效成人免疫性血小板减少症的临床研究 被引量:2

Outcome of corticosteroid-resistant adult immune thrombocytopenia treated with mycophenolate mofetil
原文传递
导出
摘要 目的:探讨以霉酚酸酯(MMF)为主的方案治疗激素无效的成人免疫性血小板减少症(ITP)的疗效和安全性。方法:回顾性分析23例服用MMF(1.0~2.0g/d)治疗的激素无效成人ITP患者,观察疗效及毒副作用。结果:MMF治疗的总体有效率为73.9%(17/23),其中6例(35.3%)完全缓解,11例(64.7%)部分缓解。MMF治疗中位起效时间为27(20~35)d,血小板计数升至峰值的中位时间为69(49~95)d。MMF治疗后,14例(82.4%)患者持续有效,随访时间为15.0(8.5~30.5)个月。MMF治疗有效患者的ITP病程明显短于MMF治疗无效患者的病程(P〈0.05);MMF联合激素、环孢素或达那唑治疗的起效时间,明显短于MMF单药治疗的起效时间(P〈0.05)。23例患者服用MMF期间未发生严重并发症。结论:MMF对于激素无效的成人ITP有较好的疗效,且毒副作用小。 Objective:To evaluate the efficacy and safety of mycophenolate mofetil(MMF)in the treatment of corticosteroid-resistant adult immune thrombocytopenia(ITP).Method:The efficacy and toxicity of MMF(1.0 to 2.0g/d)in the treatment of 23 corticosteroid-resistant adult ITP patients were retrospectively analyzed.Result:The overall response rate was 73.9%(17/23).Six(35.3%)patients achieved a complete response and 11(64.7%)patients achieved a partial response.The median time to response was 27(20 to 35)days.Peak platelet count was noted on a median of 69(49to 95)days.Fourteen(82.4%)patients sustained response after a median follow-up of 15.0(8.5 to 30.5)months.Patients who responded to MMF therapy had a shorter disease history than those who had no response(P〈0.05).Patients treated with therapy combining MMF with corticosteroid,cyclosporine or danazol responded earlier than patients treated with MMF single therapy(P〈0.05).No patients experienced severe complications during follow-up.Conclusion:MMF is effective for corticosteroid-resistant adult ITP patients with minor toxicity.
出处 《临床血液学杂志》 CAS 2016年第2期192-196,共5页 Journal of Clinical Hematology
基金 国家自然科学基金(No:81470343) 国家自然科学基金(No:81270643)
关键词 霉酚酸酯 糖皮质激素 免疫性血小板减少症 mycophenolate mofetil corticosteroid immune thrombocytopenia
  • 相关文献

参考文献2

二级参考文献30

  • 1Cines DB, Blanchette VS. Immune thrombocytopenic purpura.N Engl J Med 2002; 346: 995-1008.
  • 2Bussel JB. Novel approaches to refractory immune thrombocy-topenic purpura. Blood Rev 2002; 16: 31-6.
  • 3Becker BN. Mycophenolate mofetil. Transplant Proc 1999; 31:2777-8.
  • 4Glander P, Hambach P, Braun KP, Fritsche L, Waiser J, Mai I, et al. Effect of mycophenolate mofetil on IMP dehydrogenase after the first dose and after long-term treatment in renal transplant recipients. Int J Clin Pharmacol Ther 2003; 41: 470-6.
  • 5Gellermann J, Querfeld U. Frequently relapsing nephrotic syndrome: treatment with mycophenolate mofetil. Pediatr Nephrol 2004; 19: 101-4.
  • 6Wenzl HH, Hinterleitner TA, Aichbichler BW, Fickert P, Petritsch W. Mycophenolate mofetil for Crohn's disease: short-term efficacy and long-term outcome. Aliment Pharmacol Ther 2004;19: 427-34.
  • 7Srinivas TR, Kaplan B, Meier-Kriesche HU. Mycophenolate mofetil in solid-organ transplantation. Expert Opin Pharmacother 2003; 4: 2325-45.
  • 8Cines DB, McKenzie SE, Siegel DL. Mechanisms of action of therapeutics in idiopathic thrombocytopenic purpura. J Pediatr Hematol Oncol 2003; 25 Suppl 1: S52-6.
  • 9Narang M, Penner JA, Williams D. Refractory autoimmune thrombocytopenic purpura: responses to treatment with a recombinant antibody to lymphocyte membrane antigen CD20(rituximab). Am J Hematol 2003; 74: 263-7.
  • 10Howard J, Hofferand AV, Prentice HG, Mehta A. Mycophenolate mofetil for the treatment of refractory auto immune haemolytic anemia and auto immune thrombocytopenia purpura. Br J Haematol 2002; 117: 712-5.

共引文献197

同被引文献14

引证文献2

二级引证文献7

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部