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中国临床研究英文版:2021,34(9):1226-1228
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不同阶段原发免疫性血小板减少症的临床疗效观察
(南通大学附属南京江北医院血液科,江苏 南京 210048)
Clinical observation of primary immune thrombocytopenia at different stages
(Department of Hematology,Affiliated Nanjing Jiangbei Hospital of Nantong University,Nanjing,Jiangsu 210048,China)
摘要
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Received:January 30, 2021   Published Online:September 20, 2021
中文摘要: 目的 观察原发免疫性血小板减少症(ITP)治疗的临床疗效,探讨不同阶段ITP患者的治疗方案。方法 回顾性分析南京江北医院血液科2014年6月至2020年2月收治的246例初始以糖皮质激素治疗的ITP患者的临床疗效,观察初始糖皮质激素治疗方案无效或复发的ITP对再次使用激素治疗及行脾切除术治疗的有效率及慢性期ITP不同诊治方案的疗效。结果 对初始激素治疗有完全反应和有效且无复发的ITP患者占65.0%(160/246),初始激素治疗无效或复发的ITP患者占35.0%(86/246),用激素治疗的有效率为58.3%(28/48),采用脾切除术治疗的有效率为87.5%(7/8)。慢性期ITP的治疗采用小剂量激素联合硫唑嘌呤治疗的血小板上升的比率略高于单独小剂量激素治疗,但差异无统计学意义(P>0.05)。结论 初诊成人ITP患者的治疗首选激素治疗;对初始糖皮质激素治疗无效或复发的患者行脾切除手术疗效可靠,糖皮质激素仍有较好的疗效;治疗慢性期ITP使用小剂量糖皮质激素联合硫唑嘌呤治疗方案有较好的疗效。
Abstract:Objective To investigate the therapeutic effects of treatment options for primary immune thrombocytopenia (ITP) at different stages. Methods In 246 ITP patients who received glucocorticoid as initial treatment at Nanjing Jiangbei Hospital from June 2014 to February 2020,the effective rate of initial with glucocorticoid treatment and the effective rates of re-use hormone therapy and splenectomy for patients with ineffective initial glucocorticoid and recurrent ITP were retrospectively analyzed. The clinical effect of different treatment for chronic ITP was compared.Results The effective rates were 65.0% (160/246)for ITP patients with complete response and without recurrence,58.3% (28/48) for patients re-using hormone therapy because of ineffective initial glucocorticoid or recurrent ITP and 87.5% (7/8) for patients re-treated with splenectomy.In the treatment of chronic ITP,platelet count in the low-dose hormone combined with azathioprine group was slightly higher than that in the single low-dose hormone group,but the difference between them was not significant(P>0.05).Conclusion Hormone therapy is the first choice for treatment of newly diagnosed adult ITP patients.Both splenectomy and hormone therapy have reliable and good effects in the patients with ineffective initial glucocorticoid and recurrent ITP.Low-dose of hormone combined with azathioprine has a better effect than low- dose hormone alone in the treatment of chronic ITP.
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