摘要
目的探讨艾曲波帕联合激素治疗成人原发免疫性血小板减少症(ITP)有效性及安全性。方法选取2018年1月—2021年7月南京市溧水区人民医院收治的84例成人原发免疫性血小板减少症患者,根据治疗方案分为观察组及对照组,各42例。对照组应用激素治疗,前4 d使用地塞米松静滴,后改为泼尼松口服。观察组在此基础上联合艾曲波帕治疗,对两组治疗结果进行比较。结果观察组总有效率为95.24%,明显较对照组78.57%高,差异有统计学意义(χ^(2)=5.126,P<0.05)。两组治疗前血小板计数,差异无统计学意义(P>0.05);治疗后1、2、3、4周,观察组血小板计数均较对照组高,差异有统计学意义(t=13.180、9.050、8.072、12.695,P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD8^(+)水平差异无统计学意义(P>0.05);治疗后,观察组各指标值均较对照组高,差异有统计学意义(t=8.377、7.344、10.196,P<0.05)。观察组不良反应发生率为11.90%,与对照组7.14%相比,差异无统计学意义(χ^(2)=0.138,P>0.05)。观察组复发率为2.38%,明显较对照组19.05%低,差异有统计学意义(χ^(2)=4.480,P<0.05)。结论艾曲波帕联合激素在成人原发性ITP治疗中疗效确切,可增加血小板计数,调节免疫功能,还可预防疾病复发,且不良反应增加较少,值得应用。
Objective To investigate the efficacy and safety of Eltrombopag combined with hormones in the treatment of adults with primary immune thrombocytopenia(ITP).Methods A total of 84 adult patients with primary immune thrombocytopenia who were admitted to Lishui District People's Hospital in Nanjing from January 2018 to July 2021 were selected.According to the treatment plan,they were divided into observation group and control group,with 42 cases in each group.The control group was treated with hormones,dexamethasone was administered intravenously for the first 4 d,and then changed to oral prednisone.The observation group was combined with Eltrombopag treatment on this basis,and the treatment results of the two groups were compared.Results The total effective rate of the observation group was 95.24%,which was significantly higher than that of the control group,which was 78.57%,the difference was statistically significant(χ^(2)=5.126,P<0.05).There was no statistically significant difference in platelet count between the two groups before treatment(P>0.05),and at 1,2,3 and 4 weeks after treatment,the platelet count in the observation group was higher than that in the control group,the difference was statistically significant(t=13.180,9.050,8.072,12.695,P<0.05).Before treatment,there was no statistically significant difference in the levels of CD3^(+),CD4^(+) and CD8^(+) between the two groups(P>0.05).After treatment,the values of each index in the observation group were higher than those in the control group,and the difference was statistically significant(t=8.377,7.344,10.196,P<0.05).The incidence of adverse reactions in the observation group was 11.90%,and there was no statistically significant difference compared with 7.14% in the control group(χ^(2)=0.138,P>0.05).The recurrence rate of the observation group was 2.38%,which was significantly lower than that of the control group,which was 19.05%,the difference was statistically significant(χ^(2)=4.480,P<0.05).Conclusion Eltrombopag combined with corticosteroids is effective in the treatment of primary ITP in adults.It can increase platelet count,regulate immune function,and prevent disease recurrence,with less adverse reactions,it is worth applying.
作者
张义霞
蔡亚云
周敏
ZHANG Yixia;CAI Yayun;ZHOU Min(Department of Hematology,People's Hospital of Lishui District,Nanjing(Lishui Hospital,Zhongda Hospital Affiliated to Southeast University),Nanjing,Jiangsu Province,211200 China;Department of Hematology,Rugao People's Hospital,Nantong,Jiangsu Province,226300 China;Department of Hematology,Changshu First People's Hospital(Changshu Hospital Affiliated to Soochow University),Suzhou,Jiangsu Province,215500 China)
出处
《世界复合医学》
2022年第2期22-25,30,共5页
World Journal of Complex Medicine
