小剂量利妥昔单抗治疗免疫性血小板减少症临床效果观察  

Clinical Effect of Low-dose Rituximab in Treatment of Patients with Immune Thrombocytopenia

作　　者：李文静[1] 王志伟[1] 赵田华 王文晋[1] 侯兰芬[1] 李素欣 胡兴茂[2] LI Wen-jing;WANG Zhi-wei;ZHAO Tian-hua;WANG Wen-jin;HOU Lan-fen;LI Su-xin;HU Xing-mao(Department of Hematology,Bethune International Peace Hospital of PLA,Shijiazhuang 050082,China)

机构地区：[1]解放军白求恩国际和平医院血液科,石家庄050082 [2]解放军白求恩国际和平医院医务部计划科,石家庄050082

出　　处：《解放军医药杂志》2018年第9期80-83,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省中医药管理局科研计划项目(2018207)

摘　　要：目的探讨小剂量利妥昔单抗治疗免疫性血小板减少症(ITP)的临床效果。方法回顾性分析2014年6月—2017年1月住院治疗的90例ITP患者的临床资料。按照利妥昔单抗剂量不同分为对照组和观察组,每组45例。对照组采用标准剂量利妥昔单抗治疗,观察组采用小剂量利妥昔单抗治疗。观察比较两组的临床疗效,以及治疗前后血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、免疫球蛋白水平、CD3+和CD4+淋巴细胞水平,并记录复发及不良反应发生情况。结果两组治疗后总有效率和复发率比较差异无统计学意义(P>0.05)。治疗后,两组PLT和Ig M水平均显著高于治疗前,PT和APTT均短于治疗前(P<0.05)。治疗后,两组Ig A、Ig G、CD3+和CD4+淋巴细胞水平低于治疗前,观察组高于对照组(P<0.05)。观察组不良反应总发生率低于对照组(P<0.01)。结论小剂量利妥昔单抗治疗ITP疗效较好,对免疫功能损伤小,不良反应少,可作为临床上治疗ITP的有效方法。Objective To investigate clinical effect of low-dose of Rituximab in treatment of patients with immune thrombocytopenia （ITP）. Methods Clinical data of 90 ITP patients admitted during June 2014 and January 2017 was retrospectively analyzed, and the patients were divided into control group （ n =45） and observation group （ n =45） according to Rituximab doses. Control group was treated with standard dose of Rituximab, while observation group was treated with low-dose Rituximab. In two groups, clinical effect was compared, and levels of platelet count （PLT）, prothrombin time （PT）, activated partial thromboplastin time （APTT）, immunoglobulin level, CD3＋ and CD4＋ lymphocyte before and after treatment were observed and compared, and incidence rates of recurrence and adverse reactions were recorded. Results There were no significant differences in the total effective rate and recurrence rate after treatment between two groups （ P 〉0.05）. After treatment, in two groups, PLT and IgM levels were significantly higher, while PT and APTT were significantly shorter than those before treatment （ P 〈0.05）; IgA, IgG, CD3＋ and CD4＋ lymphocytes levels were significantly lower than those before treatment in two groups, and the levels in observation group were significantly higher than those in control group （ P 〈0.05）. The total incidence rate of adverse reactions in observation group was significantly lower than that in control group （ P 〈0.01）. Conclusion Low-dose of Rituximab in treatment of patients with immune thrombocytopenia is effective with little immunochemistry injuries and adverse reaction, and therefore it can be used as an effective method for clinical treatment of ITP.

关 键 词：利妥昔单抗 免疫性血小板减少症 治疗结果 

分 类 号：R558.2[医药卫生—血液循环系统疾病]