大剂量地塞米松与大剂量甲基强的松龙治疗成人重症特发性血小板减少性紫癜的近期疗效比较  

Effects of high-dose Dexamethason versus high-dose Methyl prednisolone for treatment in adult patients with severe idiopathic thrombocytopenic purpura

作　　者：王春森[1] 王晓冬[1] 张晋林[1] 祝彪[1] 

机构地区：[1]四川省人民医院血液科,四川成都610072

出　　处：《四川医学》2008年第5期519-520,共2页Sichuan Medical Journal

摘　　要：目的探讨大剂量地塞米松或大剂量甲基强的松龙两种方案治疗成人重症特发性血小板减少性紫癜(ITP)的临床疗效。方法110例外周血小板计数(BPC)<10×109/L的重症ITP患者分为两组:大剂量地塞米松组58例,以地塞米松40mg/d,连续口服4d,接强的松1mg/kg体重口服;大剂量甲基强的松龙组52例,以甲基强的松龙1000mg/d,静脉滴注,连用3d,接强的松1mg/kg体重口服,观察两组的临床疗效。结果大剂量地塞米松组和甲基强的松龙组的有效率分别是75.86%和80.77%,两组差异无统计学意义(P>0.05)。两组治疗有效患者,血小板上升≥50×109/L的时间,达到峰值的时间及血小板计数峰值均相近,差异无统计学意义(P>0.05)。两组均无死亡患者。结论大剂量地塞米松或大剂量甲基强的松龙治疗重症ITP均有明显疗效,两种方案疗效相近,地塞米松口服方便,更廉价,不良反应少,可以取代大剂量甲基强的松龙用于治疗重症ITP。Objective To evaluate the therapeutic effect of high-dose Dexamethasone versus high-dose methyl prednisolone in treating adult severe idiopathic thrombocytopenic purpura （ITP）. Methods 110 adult patients with severe ITP were divided into two groups. 58 patients were treated with Dexamethasone （40mg/day for 4 days） , 52 patients were treated with methyl prednisolone （1000mg/ day for 3 days） . After that, every cases was treated with prednisen [ 1 mg/（ kg.d） ] . Results There was no significant difference （ P 〉 0.05 ）in the effective rate（75.86% versus 80.77% ） ,in the time of BPC ascending to 50 × 10^9/L,aseending to the peak and BPC peak value.There was no patients died of ITP. Conclusion High-dose Dexamethason and high-dose methylprednisonlone are effective for treating adult patients with severe ITP. The therapeutic effect of two methods is similar,High-dose dexamethason is more convenient orally and cheaper than high-dose methy lprednisolone. The hlgh-dose dexamethasone might be use as first-line method to treat the adult patents with severe ITP.

关 键 词：特发性血小板减少性紫癜 地塞米松 甲基强的松龙 

分 类 号：R554.6[医药卫生—血液循环系统疾病]