标准剂量与小剂量利妥昔单抗治疗难治性免疫性血小板减少症的临床研究  

Clinical Study of Standard Dose and Small Dose of Rituxan Treating Refractory Immune Thrombocytopenia

作　　者：李丹[1] 胡俊[1] 刘顺妹[1] 郑方英[1] 许先吟[1] 

机构地区：[1]惠州市第一人民医院血液内科,广东惠州516003

出　　处：《医学综述》2015年第3期571-573,共3页Medical Recapitulate

摘　　要：目的探讨不同剂量利妥昔单抗治疗难治性免疫性血小板减少症(ITP)的临床疗效。方法选择2011年12月至2013年12月在惠州市第一人民医院血液科住院的66例原发性难治性ITP患者为研究对象,采用随机数字表法分为两组,A组32例,采用利妥昔单抗剂量为每周100 mg/m2,连用4周;B组34例,采用利妥昔单抗剂量为每周375 mg/m2,连用4周。比较两组疗效、不良反应、血小板、血小板特异性抗体。结果 A组中完全反应9例,有效14例,无效9例,总有效率为71.9%;B组中完全反应11例,有效14例,无效9例,总有效率为73.5%。两组临床疗效比较差异无统计学意义(χ2=17.45,P>0.05)。A组和B组药物治疗后均未发生输液反应,A组不良反应发生率为12.50%,低于B组的55.88%,两组发生率比较差异有统计学意义(P<0.05)。两组治疗后血小板计数均较治疗前明显升高(均P<0.05),但两组间治疗前后比较差异无统计学意义(均P>0.05)。两组治疗后血小板抗GPⅡb/Ⅲa抗体水平和抗GPⅠb/Ⅸ抗体水平均较治疗前降低(均P<0.05),但两组间治疗前后比较差异均无统计学意义(均P>0.05)。结论小剂量利妥昔单抗治疗难治性ITP疗效确切,可有效地改善临床症状,且安全性高,成本较低。Objective To study clinical curative effect of different doses of rituxan treating refractory immune thrombocytopenia（ ITP）. Methods 66 patients were randomly divided into two groups. Group A：32 patients with ITP,treated by rituxan with a dose of 100 mg / week,lasting for 4 weeks; Group A： 34 patients with ITP,treated by rituxan with a dose of 375 mg / m2,lasting for 4 weeks. Curative effect,adverse reactions,platelets,platelet specific antibody of two groups were compared. Results Two groups of clinical curative effect comparison difference had no statistical significance（ χ2= 17. 45,P〉0. 05）. Group A and group B did not occur after medical treatment transfusion reaction,the adverse reaction of group A was12. 50% lighter than group B 55. 88%,two groups the incidence of comparative difference was statistically significant（ P〈0. 05）. The two groups after treatment the platelet count were significantly higher than before treatment（ P〈0. 05）,but there was no statistically significant difference between the two groups before and after treatment（ P〉0. 05）. Two groups after treatment platelet resistance GPⅡ b / Ⅲa antibody levels and resistance to GP Ⅰ b / Ⅰ x antibody levels were lower before the treatment（ all P〈0. 05）,but between the two groups before and after treatment comparison differences had no statistical significance（ P〉0. 05）. Conclusion Curative effect of small dose of rituxan treating refractory primary ITP is good. Small dose of rituxan can effectively improve the clinical symptoms,and it has high safety and low cost.

关 键 词：免疫性血小板减少症 利妥昔单抗 小剂量 疗效 

分 类 号：R558.2[医药卫生—血液循环系统疾病]