摘要
目的分析大剂量糖皮质激素联合血小板生成素治疗难治性原发性免疫性血小板减少症的临床疗效。方法从该院于2015年1月—2016年12月期间收治的所有难治性原发性免疫性血小板减少症患者当中随机选取其中的100例作为该次试验研究对象,按照入院时间的先后顺序分为对照组和观察组;对照组给予大剂量糖皮质激素治疗,观察组在对照组基础上给予重组人血小板生成素(rhTPO)联合治疗;对比两组患者的临床治疗总有效率、不同时间段的血小板计数以及不良反应发生率。结果观察组患者的临床总有效率为94%,对照组患者的临床总有效率为72%(χ~2=9.736,P<0.05);从不同时间段的血小板计数来看,观察组患者第7天的血小板计数为(116.35±7.56)×10~9、第15天的血小板计数为(138.74±8.93)×10~9、第30天的血小板计数为(91.23±6.74)×10~9、第60天的血小板计数为(56.63±5.78)×10~9,对照组患者第7天的血小板计数为(102.23±6.41)×10~9、第15天的血小板计数为(82.52±7.89)×10~9、第30天的血小板计数为(40.56±7.46)×10~9、第60天的血小板计数为(25.06±4.84)×10~9,观察组患者从治疗后的第7天开始血小板计数明显高于对照组(t=4.014,5.713,6.513,8.316,P<0.05);观察组的不良反应发生率为8%,对照组的不良反应发生率为24%,(χ~2=9.368,P<0.05)。结论在大剂量糖皮质激素的基础上联合重组人血小板生成素进行难治性原发性免疫性血小板减少症的治疗,能够显著提高临床疗效,改善患者的血小板计数,减少不良反应的发生。
Objective To analyze the clinical efficacy of high-dose glucocorticoid combined with thrombopoietin in thetreatment of refractory primary immune thrombocytopenia. Methods 100 patients from all patients with refractory pri-mary thrombocytopenia who were admitted to the hospital from January 2015 to December 2016 were randomly selectedas the subjects of this study, according to the time of admission. The order was divided into control group and observa-tion group; the control group was treated with high dose of glucocorticoid, and the observation group was given com-bined with recombinant human thrombopoietin （rhTPO） on the basis of the control group; the clinical treatment effectiverate and different platelet counts during the time period and the incidence of adverse reactions were compared betweenthe two groups. Results The total effective rate was 94% in the observation group and 72% in the control group （字2=9.736, P约0.05）. From the platelet count in different time periods, the observation group was on the 7th day. The plateletcount was （116.35±7.56×109, the platelet count on day 15 was （138.74±8.93×109, the platelet count on day 30 was（91.23±6.74×109, and the platelet count on day 60 was （56.63±5.78×109. The platelet count of the group on day 7was （102.23±6.41×109, the platelet count on day 15 was （82.52±7.89×109, the platelet count on day 30 was （40.56±7.46×109, and the platelet count on day 60 was （25.06±4.84×109, the platelet count of the observation group was sig-nificantly higher than that of the control group on the 7th day after treatment （t=4.014,5.713,6.513,8.316,P约0.05）; theincidence of adverse reactions in the observation group was 8%, and the incidence of adverse reactions in the controlgroup was 24%（χ2=9.368, P〈0.05）. Conclusion Combined with recombinant human thrombopoietin for the treatment ofrefractory primary immune thrombocytopenia based on high-dose glucocorticoids, it can significantly improve clinicalefficacy, improve patient platelet count, and reduce adverse reactions.
作者
周颖
ZHOU Ying(Department of Hematology,the First People＇s Hospital of Wujiang District,Suzhou,Jiangsu Province,215200 China)
出处
《系统医学》
2018年第20期43-45,共3页
Systems Medicine
