ITP诊旨拔中国专家共识.ppt

* * * * * * * * * * * * * * * 两种统计方式均表明治疗组疗效显著高于对照组. * * * * * * * * * * * * * * * * * 大剂量甲基强的松治疗ITP 传统剂量甲基强的松 Vs 大剂量甲基强的松治疗ITP Bilqir O, et al. Transfus Apher Sci 2011;44(3):239-42 研究对象 成年ITP患者，首次诊断后接受其他药物治疗，选取对治疗无反应、激素依赖、血小板计数很低或者血小板计数高于30,000/L但发生出血的患者进行研究。 共50例患者。 Material and methods Bilqir O, et al. Transfus Apher Sci 2011;44(3):239-42 Material and methods 随机分组 -- arm A（30例）：口服methylprednisolone 1mg/kg/d； -- arm B（20例）：口服methylprednisolone 30mg/kg/d, d1-3， 20mg/kg/d, d4-7; 10mg/kg/d, 至治疗结束。 Bilqir O, et al. Transfus Apher Sci 2011;44(3):239-42 Conclusion Bilqir O, et al. Transfus Apher Sci 2011;44(3):239-42 high dose steroid (HDS)组的疾病持续时间显著短于conventional dose steroid (CDS)组 (2 ± 2,3 vs. 4 ± 3,8 years; p = 0009)。 两组间患者诊断时发生的临床症状无明显差异 (p 0.05)。 治疗第3、5、7天时，HDS组血小板计数的增加量显著高于CDS组(p 0.05)。 HDS可缩短患者住院时间，降低威胁患者生命的血小板计数减低的发生率。 两组间的副反应发生率无显著差异 Bilqir O, et al. Transfus Apher Sci 2011;44(3):239-42 Conclusion 静脉免疫球蛋白 Vs 大剂量甲基强的松治疗ITP的随机多中心临床试验 Godeau B, et al. Lancet 2002;359(9300):23-9 入组标准 IVIg=intravenous immunoglobulin; HDMP=high-dose methylprednisolone; pred=prednisone. Bilqir O, et al. Transfus Apher Sci 2011;44(3):239-42 短期和长期预后 HDMP=high-dose methylprednisolone; IVIg=intravenous immunoglobulin; pred=prednisone. NA=not available. Data are median (IQR) for continuous variables and number of patients (%) for discrete variables (unless otherwise stated). *Test for interaction between the two randomisation procedures, based on generalised linear modelling with F-test logistic model or Cox’s model with likehood ratio test. ?Comparison of outcome between IVIg-pred and HDMP-pred (ie, effect of randomisation A in the subset of patients who received pred after randomisation B), based on non-parametric Wilcoxon’s rank sum test or Fisher’s exact test. ?Platelet cou