两种方法治疗成人重型特发性血小板减少性紫瘢的疗效对比  

Observation on effect of two therapies on severe idiopathic thrombocytopenic purpura

作　　者：郑英梦[1] 施子诺[1] 

机构地区：[1]泉州市第一医院检验科,福建泉州362000

出　　处：《现代医药卫生》2010年第9期1297-1298,共2页Journal of Modern Medicine & Health

摘　　要：目的:探讨大剂量地塞米松与大剂量丙种球蛋白两种方法治疗成人重型特发性血小板减少性紫癜(ITP)的疗效。方法:对入院时外周血小板计数(PLT)<10×109/L且出血倾向明显105例重症ITP患者随机分为两组:大剂量地塞米松组(A组)54例,用地塞米松40mg/d连续口服4d,强的松1mg/kg体质量口服;大剂量丙种球蛋白组(B组)51例,丙种球蛋白0.4g·kg-1.d连续静脉滴注5天,强的松1mg/kg体质量口服,连续监测治疗效果。结果:大剂量地塞米松组(A组)和大剂量丙种球蛋白组(B组)的总有效率分别是70.4%和92.2%,两组差异有显著性(P<0.05)。A组、B组PLT≥50×109/L时间分别为(3.8±1.2)天,(2.9±1.4)天;≥100×109/L时间分别为(6.5±1.8)天,(5.1±1.9)天;PLT的峰值(×109/L)分别为(320±69)×109/L,(351±120)×109/L。结论:大剂量丙种球蛋白升高血小板效果比大剂量地塞米松好,而且大剂量丙种球蛋白使PLT上升更迅速,峰值高,上升至正常稳定时间长。Objective：To evaluate the effectiveness of high-dose dexamethasone and high-dose immunoglobulin in adult severe idiopathic thrombocytopenic purpura （ITP）. Methods：110 adult patients hospitalized with PLT≤10×10^9/L and tendency of hemorrhage were randomly divided into two groups：high-dose dexamethasone（A group）,54 patients were treated with high-dose dexamethasone （40 mg/d for 4 d）;high-dose immunoglobulin（B group）,51 patients were treated with high-dose immunoglobulin （0.4 g/d for 5 d）.After that,every case was treated with prednison [1 mg/（kg·d）].Results：There was remarkably significant difference （P〈0.05） in the effective rate （70.4% versus 92.2%）,between the two groups,the times of PLT≥50×10^9/L were （3.8±1.2）d and （2.9±1.4）d;the times of PLT≥100×10^9/L were （6.5±1.8）d and（5.1±1.9）d,PLT-peak values（×10^9/L）were （320±69）and（351±120） respectively. Conclusion：High-dose immunoglobulin is more rapid and effective and superior to high-dose dexamethasone in increasing the platelet count in severe ITP,and longer in making platelets rosen to normal and stable time.

关 键 词：特发性血小板减少性紫癜 重型 丙种球蛋白 地塞米松 

分 类 号：R5[医药卫生—内科学]