中等剂量地塞米松治疗免疫性血小板减少症的疗效观察  

Efficacy and safety of moderate-dose dexamethasone on primary immune thrombocytopenia

作　　者：洪铁艳[1] 

机构地区：[1]东南大学医学院附属南京同仁医院血液肿瘤科,江苏南京211102

出　　处：《现代医学》2015年第12期1536-1539,共4页Modern Medical Journal

摘　　要：目的:探讨中等剂量地塞米松治疗原发性免疫性血小板减少症患者的疗效与不良反应。方法:选取初治原发性免疫性血小板减少症患者15例,用地塞米松15 mg静脉滴注,连用3 d,复查血常规,如血小板有上升趋势且无明显出血征象可继续使用地塞米松15 mg维持3 d,后依次改为地塞米松10 mg静脉点滴3 d、5 mg静脉点滴3 d,泼尼松40 mg口服,每周减5 mg。并与我国一份前瞻性随机临床研究27例大剂量地塞米松治疗免疫性血小板减少症结果相比较。如地塞米松治疗3 d后血小板无上升趋势,且有出血征象加用静脉注射人丙种球蛋白或改用其他方案。结果:使用中等剂量地塞米松患者9 d治疗反应率为73.33%(11/15),2个月治疗反应率为66.67%(10/15),与大剂量地塞米松治疗疗效相当,且患者耐受良好,无因不良反应停药现象发生。结论:中等剂量地塞米松治疗免疫性血小板减少症患者耐受性好、不良反应少,且疗效与大剂量地塞米松治疗相当。Objective： To investigate the effect of moderate-dose dexamethasone on primary immune thrombocytopenia（ IPT）. Methods： A total of 15 IPT patients were chosen and treated with dexamethasone at a dosage of 15 mg·d^（-1）for3 consecutive days,and if platelet had increasing trend and no obvious new bleeding,the treatment could continue with15 mg ·d^（-1）dexamethasone for another 3 days,after that,the treatment could be changed in turn with 10 mg ·d^（-1）dexamethasone for 3 days,5 mg·d^（-1）for 3 days,40 mg·d^（-1）prednisone with reduction of 5 mg per week. If there was no increasing trend after treatment with 15 mg·d^（-1）dexamethasone for 3 days,change another treatment. Results： The respond rate of patients after 9 days and 2 months treatment were 73. 33%（ 11 /15） and 66. 67%（ 10 /15） respectively.The effect of treatment was the same as large dosage of dexamethasone, and the patients were well tolerated.Conclusion： The moderate dose dexamethasone in the treatment of ITP,patients with good tolerability and the efficacy equivalent to high-dose dexamethasone treatment.

关 键 词：免疫性血小板减少症 中等剂量地塞米松 大剂量地塞米松 

分 类 号：R453.9[医药卫生—治疗学] R558.2[医药卫生—临床医学]