重组人血小板生成素联合环孢素A治疗难治性ITP的疗效观察  

作　　者：吴功强[1] 罗秋[1] 莲陈瑾 

机构地区：[1]温州医科大学附属义乌医院血液科,322000

出　　处：《浙江临床医学》2015年第6期892-893,896,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生一般研究计划（2011KYB156）

摘　　要：目的：观察重组人血小板生成素（rhTPO）联合环孢素A（CsA）治疗难治性免疫性血小板减少症（ITP）的疗效及安全性。方法26例难治性ITP患者采用rhTPO（15000U/d，d1-14）联合口服CsA[剂量2-3mg/（kg.d）]。观察治疗前后血小板数及T淋巴细胞亚群，并观察药物的毒副反应。结果经1周、2周及1个月治疗后总有效率分别为61.6%、92.3%和84.6%；而1、2、3个月治疗后复发率分别为7.7%、19.2%和26.9%。治疗后ITP患者血小板数明显升高，与治疗前比较差异有显著性（P〈0.05）。CD4/CD8比值明显升高，与治疗前比较差异有显著性（P〈0.05）。毒副反应轻微。结论 rhTPO联合CsA治疗难治性ITP效果确切。其可能主要通过调节T细胞起治疗作用。Objective To observe the efficacy and safety of recombinant human thrombopoietin （rhTPO） in combination with cyclosporin A （CsA） for the treatment of patients with refractory immune thrombocytopenia （RITP）. Methods Twenty-six patients with RITP received subcutaneous injection of rhTPO at a dose of 15000U once daily up to day 14. Simultaneously they also received oral CsA at a dose of 2-3mg·kg-1·d-1 for three months. Platelet counts and T cell subsets were monitored before and after treatment. Also the side effects were observed. Results The total effective rate was 61.6%,92.3% and 84.6% respectively after one-week,two-week and one-month treatment. The relapse rate was 7.7%, 19.2% and 26.9% respectively after one-month,two-month and three-month treatment. Platelet counts after treatment were significantly higher than before （P〈0.05）. The specific value of CD4/CD8 was also increased significantly （P〈0.05）. All the adverse events were generally mild. Conclusion Combination therapy with rhTPO and CsA was effective and well tolerated in the management of patients with RITP. The efficacy may be related with regulation of T cell.

关 键 词：重组人血小板生成素 环孢素A 难治性免疫性血小板减少症 

分 类 号：R558.2[医药卫生—血液循环系统疾病]