成人难治及复发ITP的个体化治疗及研究进展  

Individualizing Treatment of Refractory and Relapsed ITP in Adults and Its Development of Study——Review

作　　者：黄玉[1,2] 李薇[2] 杨波[1] 朱宏丽[1] 党艳辉[1,2] 

机构地区：[1]解放军总医院老年血液科,北京100853 [2]吉林大学第一临床医院肿瘤中心,吉林长春130021

出　　处：《中国实验血液学杂志》2009年第6期1609-1615,共7页Journal of Experimental Hematology

基　　金：国家自然科学基金;编号:30772597

摘　　要：免疫性血小板减少性紫癜(ITP)是血液系统的常见疾病,以出血、外周血血小板减少为主要临床特征。成人常呈慢性病程,其中11%-35%可发展为难治性ITP。调查研究显示,ITP发病与基因多态性有关。目前对于难治/复发性ITP的治疗还没有定论,从一定程度上说,其治疗依赖于患者的治疗需要和对治疗的反应。本综述的目的旨在为目前参差不齐的治疗策略提供临床参考。本文论述了难治/复发性ITP的所有治疗方案,并着重论述了新的疗法,包括抗CD20单克隆抗体、血小板生成素样物质、TPO受体激动剂和造血干细胞移植,在我国泛细胞保护剂也显示了较好的临床疗效。总之,最重要的是根据ITP患者的具体情况给予个体化治疗。Idiopathic thrombocytopenic purpura （ITP） is a common hematological disease. It bleeds with peripheral blood platelete reduction as the main clinical manifestation, and manifests a chronic history in adult people. 11% - 35% ITP patients develop into a refractory course, which may be related with gene polymorphisms. There is currently no consensus on how best to manage refractory/relapsed ITP. In part, this reflects the need for individualized treatment due to the patients＇requirements and their responsiveness to therapies. The objective of this review is to provide a clinically useful guide to current management strategies. This article summarizes all the treatment for refractory ITP, and highlights new therapies, including the anti-CD20 antibody, thrombopoietic agents, TPO receptor agonist and HSCT. The pancytoprotector shows good effect in the treatment of refractory and relapsed ITP in China. In a word, to give different treatments individually is most important.

关 键 词：免疫性血小板减少性紫癜 难治复发免疫性血小板减少性紫癜 个体化治疗 

分 类 号：R558.2[医药卫生—血液循环系统疾病]