大剂量地塞米松联合海曲泊帕治疗原发性免疫性血小板减少症效果分析  

Effect analysis of high-dose dexamethasone combined with rafutrombopag in the treatment of primary immunologic thrombocytopenic purpura

作　　者：赵会英 马圣宇 杨云 李雪雪 ZHAO Huiying;MA Shengyu;YANG Yun;LI Xuexue(Department of Hematology,Suzhou Municipal Hospital of Anhui Province,Suzhou 234000,Anhui Province,China)

机构地区：[1]安徽省宿州市立医院血液科,安徽宿州234000

出　　处：《世界临床药物》2025年第2期164-169,共6页World Clinical Drug

摘　　要：目的 观察大剂量地塞米松(dexamethasone,DXM)联合海曲泊帕治疗新诊断原发性免疫性血小板减少症(immunologic thrombocytopenic purpura,ITP)的效果。方法 纳入2020年6月至2023年6月我院新诊断原发性ITP患者80例,以区组随机法将其分为对照组(大剂量DXM)和研究组(大剂量DXM+海曲泊帕),每组40例。比较两组治疗前和治疗D7、D14、D30、D60的血小板计数(platelet count,PLT)水平、T淋巴细胞亚群分布,以及疗效和不良反应发生情况。结果 治疗D7、D14、D30、D60,两组PLT水平较前均升高(P<0.05),且研究组治疗D7、D14、D30的PLT水平较对照组更高(P<0.05)。治疗后,两组白细胞分化抗原(cluster of differentiation,CD)3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、补体C3、补体C4及补体白介素(interleukin,IL)-4水平较前均升高(P<0.05),且研究组高于对照组(P<0.05)。两组CD8^(+)、IL-2、IL-10、干扰素水平较前均降低(P<0.05),且研究组低于对照组(P<0.05)。研究组治疗总有效率高于对照组(85.00% vs.65.00%,P<0.05),DXM二次给药率(10.00% vs.30.00%,P<0.05)、不良反应发生率(25.00% vs.52.50%,P<0.05)均低于对照组。结论 大剂量DXM联合海曲泊帕可有效上调新诊断原发性ITP患者PLT水平,改善T淋巴细胞亚群分布,提高疗效,并且可降低DXM二次给药率及不良反应发生率。Objective To observe the efficacy of high-dose dexamethasone(DXM) combined with rafutrombopag in the treatment of newly diagnosed primary immunologic thrombocytopenic purpura(ITP).Methods A total of 80 newly diagnosed primary ITP patients in our hospital from June 2020 to June 2023 were enrolled and divided into control group(high-dose DXM) and study group(high-dose DXM+rafutrombopag) by district randomization method,with 40 cases in each group.Platelet count(PLT) levels,the distribution of T lymphocyte subsets,efficacy and the occurrence of adverse reactions were compared between the two groups before treatment and at D7,D14,D30 and D60 of treatment.Results At D7,D14,D30 and D60 of treatment,the PLT levels in both groups were higher than before(P<0.05),and the PLT levels of the study group were higher than those in the control group at D7,D14 and D30(P<0.05).After treatment,cluster of differentiation(CD)3^(+),CD4^(+),CD4^(+)/CD8^(+),complement C3,complement C4 and interleukin(IL)-4 in both groups were increased compared with those before treatment(P<0.05),and the study group was higher than the control group(P<0.05).The levels of CD8^(+),IL-2,IL-10 and interferon in both groups were lower than before treatment(P<0.05),and the study group was lower than the control group(P<0.05).The total effective rate of the study group was higher than that of the control group(85.00% vs.65.00%,P<0.05),the rate of DXM secondary administration(10.00% vs.30.00%,P<0.05) and the incidence of adverse reactions(25.00% vs.52.50%,P<0.05) were lower than those of the control group.Conclusion High-dose DXM combined with rafutrombopag in the treatment of newly diagnosed primary ITP can effectively up-regulate PLT level,improve the distribution of T lymphocyte subsets,improve efficacy,and reduce the rate of DXM secondary administration and the incidence of adverse reactions.

关 键 词：大剂量地塞米松 海曲泊帕 原发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]