大剂量地塞米松和常规剂量泼尼松治疗成人免疫性血小板减少症的临床研究  

Clinical studies on the treatment of adult immune thrombocytopenia with high-dose dexamethasone and conventional-dose prednisone

作　　者：李淑美[1] 郝云良[1] 杨水个 

机构地区：[1]济宁市第一人民医院血液科,山东济宁272100

出　　处：《临床血液学杂志》2014年第1期26-28,共3页Journal of Clinical Hematology

摘　　要：目的:比较大剂量地塞米松和常规剂量泼尼松一线治疗成人免疫性血小板减少症(ITP)的疗效及安全性。方法:将成人ITP患者87例随机分为A、B组,A组42例采用大剂量地塞米松治疗;B组45例采用常规剂量泼尼松治疗,无效后再给予大剂量地塞米松治疗,比较2种治疗方案的疗效及安全性。结果:A组有效率为83.3%,B组为68.9%,2组比较差异无统计学意义(P>0.05)。A组随访35例,长期缓解率为60.0%;B组随访31例,长期缓解率为35.5%,2组比较差异有统计学意义(P<0.05)。A组患者不良反应轻微,无一例并发感染;B组所有患者均出现不同程度的类库欣综合征表现,部分患者并发感染。结论:大剂量地塞米松治疗方案治疗成人ITP的疗效高、维持时间长、不良反应小,优于常规剂量泼尼松治疗方案。Objective：To compare the efficacy and safety of first-line treatment of adult immune thrombocyto-penia（ITP）with high-dose dexamethasone（Dex）and conventional-dose prednisone（Pred）.Method：A total of 87 cases of adult ITP were randomly divided into group A（n=42）and group B（n=45）.Patients in group A received high-dose Dex therapy,patients in group B received conventional doses of Pred treatment and then given large do-ses Dex treatment if no response.We compared the efficacy and safety of two kinds of treatment.Result：The effec- tive rates of group A and group B were 83.3%and 68.9%respectively（P〉0.05）.The long-term remission rate was 60.0%in 35cases of group A and 35.5%in 31cases of group B（P〈0.05）.Adverse reactions in group A were mild without concurrent infections.Patients in group B had various degree of Cushing＇s syndrome manifesta-tions and some patients had infections.Conclusion：High-dose Dex regimen is superior to conventional doses of Pred in adult ITP,wiht higher efficacy,longer duration and less side effects.

关 键 词：大剂量地塞米松 免疫性血小板减少症 常规剂量泼尼松 

分 类 号：R558.2[医药卫生—血液循环系统疾病]