甲泼尼龙冲击治疗重症特发性血小板减少性紫癜的临床观察  

Methylprednislone in treatment of severe idiopathic thrombocytopenic purpura.

作　　者：王艳玲[1] 刘占凤[1] 杜志刚[1] 刘海涛[1] 陈乃耀[1] 高峰[2] 朱梦波[2] 

机构地区：[1]华北煤炭医学院附属医院血液内科,河北省唐山市063000 [2]唐山钢铁公司医院血液科

出　　处：《中国综合临床》2007年第8期708-709,共2页Clinical Medicine of China

摘　　要：目的观察大剂量甲泼尼龙冲击治疗重症特发性血小板减少性紫癜（ITP）的疗效。方法将63例重症ITP患者随机分为治疗组与对照组，治疗组用甲泼尼龙1000mg／d，静脉滴注，共3d，以后改口服泼尼松1～2mg／（kg·d）；对照组用泼尼松1—2mg／（kg·d）。结果在治疗第2～5天，血小板计数〉50×10^9／L者。治疗组分别为1、10、19、19例，对照组分别为0、0、2、2例，2组比较差异有统计学意义（P〈0．01）；平均止血天数治疗组（3．6±2．2）d，对照组（8．3±4．2）d，2组差异有统计学意义（P〈0．05）；2周时治疗组总有效率93．7％，对照组总有效率为80．6％，2组疗效差并有统计学意义（P〈0．05）。但治疗21d时。重新评价疗效2组比较差异无统计学意义（P〉0．05）。结论对于重症ITP患者，大剂量甲泼尼龙冲击治疗有积极意义，尤其适用于口服泼尼松有禁忌者。而对于出血倾向不重者，传统治疗仍有一定价值。Objective To evaluate the clinical efficacy of high dose Methylprednisolong（MP） on idiopathic thromboeytopenic purpura （ITP）. Methods 63 patients with severe riP were divided into treatment and control group at random. The treatment group was given MP at a dose of 1000 nag per day,for three days,whereas control group was given prednisone 1 - 2 nag/kg per day. Results On day 2 to day 5 ,the numbers of patients whose PTC 〉 50 × 10^9/L in MP group was 1,10,19,19 and in control group was 0,0,2,2, respeetively. The ratio of the total effieleney was 93.7 % in the treatment group and 80.6 % in control group, respectively. The clinical efficacy was different significant between groups after 2 weeks （ P 〈 0.05 ） , but was not after 3 weeks （ P 〉 0.05 ）. Conclusion High dose MP is more effective in the patients and with obvious hemorrhagic tendency than that those of the traditional treatment ; whereas the traditional treatment is available for other severe ITP patients .

关 键 词：特发性血小板减少性紫癜 甲泼尼龙 对照研究 

分 类 号：R554.6[医药卫生—血液循环系统疾病]