小剂量利妥昔单抗治疗老年慢性难治性免疫性血小板减少症的临床研究  

Clinical study of low dose rituximab for the therapy in elderly patients with chronic refractory immune thrombocytopenia

作　　者：郭素丽[1] 陈娜飞[1] 魏秋平[1] 陈铁虎[2] 

机构地区：[1]河北省邢台市人民医院血液科,054000 [2]冀中能源邢台矿业集团总医院检验科,河北邢台054000

出　　处：《重庆医学》2013年第34期4155-4156,4159,共3页Chongqing medicine

摘　　要：目的研究小剂量利妥昔单抗(rituximab)治疗老年慢性难治性免疫性血小板减少症(ITP)的疗效和安全性。方法收集河北省邢台市人民医院血液科36例老年慢性难治性ITP患者,静脉注射rituximab 100mg,每周1次,共4周。观察疗效和不良反应,随访12月。比较治疗前后血小板(PLT)、白细胞(WBC)、白细胞分化抗原8+(CD8+)、CD19+淋巴细胞数和免疫球蛋白(IgG,IgM,IgA)的区别。结果治疗后患者完全反应(CR)17例(47.2%),有效(R)11例(30.6%),无效(NR)8例(22.2%),2例患者发生轻度头晕、胸闷;患者治疗后PLT显著上升(P=0.001),CD19+淋巴细胞数明显下降(P=0.001),WBC、CD8+淋巴细胞数和血清免疫球蛋IgG、IgM、IgA治疗前后无明显变化(P>0.05)。结论小剂量rituximab治疗老年难治性ITP具有较好的临床效果、不良反应轻微,可作为老年慢性难治性ITP的有效治疗方案之一。Objective To study the efficacy and safty of low dose rituximab therapy in elderly patients with chronic refractory immune thrombocytopenia（ITP）. Methods 36 elderly patients with chronic refractory ITP were collected from Xingtai People＇s Hospital of Hebei,the patients were given intravenous injection of intravenous rituximab at the dose of 100 mg once weekly for 4 consecutive weeks,observing the efficacy and adverse reaction and following up for 12 months. Difference of platelet （PLT） ,white blood cell （WBC）, cluster differentiation 8 ＋ （CD8 ＋ ）, CD19 ＋ eukomonocyte number and immunoglobulin（IgG, IgM, IgA） were compared before and after treatment. Results The responses of complete remission （CR）were 17 casese（47.2%）, remission （R） were 11 casese （30.6~） and no remission （NR） 8 casese （22.2%） respectively, 2 patients experienced mild dizziness and chest tightness; PLT were significantly increased （P ： 0. 001 ） after treatment, CD19＋ lymphocyte count decreased significantly （P = 0. 001）, WBC,CD8＋ lymphocyte and serum immunoglobulin IgG, IgM, IgA showed no significant difference before and after treatment（P〈0.05）. Conclusion Low dose rituximab had better clinical efficacy for the treatment of elderly patients with chronic refractory ITP,low dose rituximab may be a effective treatment in elderly chronic refractory ITP patients with minor adverse reactions.

关 键 词：血小板减少 难治病 利妥昔单抗 老年人 

分 类 号：R558.2[医药卫生—血液循环系统疾病]