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吗替麦考酚酯联合糖皮质激素治疗难治性特发性血小板减少性紫癜的临床观察 被引量:10

Clinical Observation of Mycophenolate Mofetil Combined with Glucocorticoid in the Treatment of Refractory Idiopathic Thrombocytopenic Purpura
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摘要 目的:考察吗替麦考酚酯联合糖皮质激素治疗难治性特发性血小板减少性紫癜(ITP)的疗效和安全性。方法:134例难治性ITP患者按照随机数字表法分为观察组和对照组,各67例。对照组患者口服醋酸泼尼松片,每日0.5 mg/kg,分早晚2次服用;观察组患者在对照组治疗的基础上口服吗替麦考酚酯分散片,每次1 g,bid。两组患者均以3周为1个疗程,根据患者病情治疗3~5个疗程。比较两组患者的临床疗效、治疗前后血小板计数(PLT)动态变化、治疗满意度和不良事件发生情况。结果:观察组患者的总有效率(91.04%)显著高于对照组(74.63%),差异有统计学意义(P〈0.05);观察组患者治疗后7、14、21 d的PLT显著大于对照组,差异有统计学意义(P〈0.05);观察组患者的总满意度显著高于对照组(89.55%vs.80.60%),不良事件发生率显著低于对照组(2.99%vs.10.44%),差异均有统计学意义(P〈0.05)。结论:吗替麦考酚酯联合糖皮质激素治疗难治性ITP,能显著提高临床疗效、PLT和患者满意度,且安全性较好。 OBJECTIVE : To investigate the therapeutic efficacy and safety of mycophenolate mofetil combined with glucocorti- coid in the treatment of refractory idiopathic thrombocytopenic purpura (ITP). METHODS: 134 cases of refractory ITP were randomly divided into observation group and control group, with 67 cases in each group. Control group was given Prednison acetate tablet orally, 0.5 mg/kg each day, morning and evening. Observation group was additionally given Mycophenolate mofetil dispers- ible tablet, 1 g/time, bid. A treatment course lasted for 3 weeks, and both groups received 3-5 courses of treatment. Clinical efficacy of 2 groups were compared as well as the change of PLT before and after treatment, satisfaction degree of treatment and adverse event. RESULTS: The total effective rate of observation group (91.04%) was significantly higher than that of control group (74.63%), with statistical significance (P〈0.05); PLT of observation group was significantly greater than that of control group 7, 14 and 21 d after treatment, with statistical significance (P〈0.05) ; total satisfactory degree of observation group was significantly higher than that of control group (89.55% vs. 80.60% ), and the incidence of adverse event was significantly lower than control group (2.99 % vs. 10.44 % ), with statistical significance (P〈0.05). CONCLUSIONS: Mycophenolate mofetil combined with glu- cocorticoid can improve clinical efficacy, PLT and satisfactory degree significantly in the treatment of refractory ITP with good safety.
作者 李云 党惠兵
出处 《中国药房》 CAS 北大核心 2016年第20期2819-2821,共3页 China Pharmacy
关键词 吗替麦考酚酯 糖皮质激素 难治性特发性血小板减少性紫癜 Mycophenolate mofetil Glucocorticoid Refractory idiopathic thrombocytopenic purpura
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