小剂量泼尼松联合艾曲泊帕在成人慢性原发免疫性血小板减少症治疗中的应用研究  

Study on the application of low-dose prednisone combined with eltrombopag in the treatment of adult chronic primary immune thrombocytopenia

作　　者：黄远颖 杨秋敏 沈丽君 张湘兰 司徒健瑜 李孔扬 HUANG Yuanying;YANG Qiumin;SHEN Lijun;ZHANG Xiangan;SITU Jianyu;LI Kongyang(Department of Hematology,People’s Hospital of Yangjiang,Guangdong,Yangjiang 529200,China;Department of Hepatobiliary Pancreatic Surgery,People’s Hospital of Yangjiang,Guangdong,Yangjiang 529200,China)

机构地区：[1]广东省阳江市人民医院血液内科,广东阳江529200 [2]广东省阳江市人民医院肝胆胰外科,广东阳江529200

出　　处：《中国医药科学》2023年第22期94-97,共4页China Medicine And Pharmacy

基　　金：广东省阳江市医疗卫生类科技计划项目(SF2021020)。

摘　　要：目的探讨小剂量泼尼松联合艾曲泊帕在成人慢性原发免疫性血小板减少症(ITP)治疗中的应用效果。方法选择2021年7月至2023年1月阳江市人民医院收治的成人慢性ITP患者62例,根据随机数表法分为试验组(给予小剂量泼尼松联合艾曲泊帕治疗,n=31)与对照组(给予艾曲泊帕治疗,n=31)。记录两组患者不同时间点血小板计数(PLT)、治疗起效时间、临床出血情况、疗效及不良反应并进行分析。结果治疗后,两组患者PLT高于治疗前,且试验组PLT明显高于对照组,两组组间(F=61.453,P<0.001)、不同时间点(F=49.978,P<0.001)、组间与不同时间点交互作用(F=16.162,P<0.001)比较,差异有统计学意义,治疗后1、4、8、12周试验组PLT均明显高于对照组,差异有统计学意义(P<0.05)。试验组治疗起效时间(6.42±1.13)d明显短于对照组(8.95±1.56)d,试验组治疗后出血分级明显优于对照组,差异有统计学意义(P<0.05)。试验组治疗总有效率为93.55%,明显高于对照组的74.19%,差异有统计学意义(P<0.05)。试验组复发率为3.23%,略低于对照组的9.68%,差异无统计学意义(P>0.05)。试验组不良反应总发生率为12.90%,明显低于对照组的38.71%,差异有统计学意义(P<0.05)。结论小剂量泼尼松联合艾曲泊帕治疗成人慢性ITP可有效缩短起效时间,提高PLT水平及改善临床出血情况,疗效较好且安全性较高,可作为治疗成人慢性ITP的有效方案。Objective To explore the application effect of low-dose prednisone combined with eltrombopag in the treatment of adult chronic primary immune thrombocytopenia(ITP).Methods A total of 62 adult patients with chronic ITP admitted to People’s Hospital of Yangjiang from July 2021 to January 2023 were included and divided into the test group(treated with low-dose prednisone combined with eltrombopag,n=31)and the control group(treated with eltrombopag,n=31)according to the random number table method.The platelet count(PLT),treatment onset time,clinical bleeding,efficacy,and adverse reactions of the two groups of ITP patients at different time points were recorded and analyzed.Results After treatment,both groups of patients showed a significant increase in PLT,while the increase in PLT in the test group was significantly greater than that in the control group.The PLT between the two groups(F=61.453,P<0.001),at different time points(F=49.978,P<0.001),and the interaction between the groups at different time points(F=16.162,P<0.001)were statistically significant.Moreover,the PLT of ITP patients in the test group was significantly higher than that of the control group at 1 week,4 weeks,8 weeks,and 12 weeks after treatment,with statistically significant differences(P<0.05).The treatment onset time of the test group(6.42±1.13)days was significantly shorter than that of the control group(8.95±1.56)days.After treatment,the bleeding grading of the test group was significantly better than that of the control group,with statistically significant differences(P<0.05).The total effective rate of treatment in the test group was 93.55%,significantly higher than 74.19%in the control group,with statistically significant difference(P<0.05).The recurrence rate of 3.23%in the test group was slightly lower than that of 9.68%in the control group,without statistically significant difference(P>0.05).The total incidence of adverse reactions in the test group was 12.90%,significantly lower than 38.71%in the control group,with statistically sig

关 键 词：泼尼松 艾曲泊帕 原发免疫性血小板减少症 血小板计数 

分 类 号：R558.2[医药卫生—血液循环系统疾病]