VP方案与大剂量丙种球蛋白治疗成人特发性血小板减少性紫癜疗效比较.docVIP

VP方案与大剂量丙种球蛋白治疗成人特发性血小板减少性紫癜疗效比较 　　【摘要】 目的 比较VP方案和大剂量丙种球蛋白(HDIVIG)治疗成人特发性血小板减少性紫癜(ITP)的临床疗效。方法 2006年 1月至2009年1月收治的56例ITP患者,随机分为两组:VP方案组(A组)21例:以长春新碱2 mg缓慢静脉滴注,每周1次,连用6周,以后每2周1次,共4次,同时联用强的松口服1 mg/(kg#8226;d),有效后强的松逐渐减量至停用;HDIVIG组(B组)35例:给予IVIG0.4 g/(kg#8226;d),5 d为1个疗程,观察两组的临床疗效。结果 A组和B组有效率分别为57.1%和85.7%,两组比较差异有统计学意义(χ2=5.71,P0.05)。结论 VP方案和HDIVIG方案治疗ITP均取得一定疗效,其中HDIVIG方案疗效优于VP方案。 　　【关键词】 特发性血小板减少性紫癜; VP方案; 大剂量丙种球蛋白 　　 　　Effects of VP versus HDIVIG in treatment of adult patients with idiopathic thrombocytopenic purpura 　　 　　XU Dong-hui. 　　Department of Hematology,Qingpu Branch, Zhongshan Hospital affiliated to Fudan University, Shanhai 201700,China 　　 　　【Abstract】 Objective To compare the effects of VP versus HDIVIG in treatment of adult patients with idiopathic thrombocytopenic purpura(ITP). Methods January 2006 to January 2009, 56 patients in our hospital with ITP were randomly divided into 2 groups. VP group (group A): 21 cases were treated with VCR 2 mg (once a week for 6 times, then once every 2 week for 4 times). Meanwhile, with oral treatment of prednisone 1 mg/(Kg#8226;d) and reduced gradually till drug withdrawal; HDIVIG group(group B): 35 cases were treated with HDIVIG [0.4 g/(Kg#8226;d) for 5 days].Clinical efficiency of 2 groups were observed. Results The effective rate was 57.1 % in group A and 85.7% in group B, respectively. There was significant difference in 2 groups(χ2=5.71,P0.05). Conclusion VP and HDIVIG are effective for treating adult patients with idiopathic thrombocytopenic purpura,HDIVIG has signifficant effect than VP. 　　【Key words】 Idiopathic thrombocytopenic purpura; VP;HDIVIG 　　 　　作者单位:201700复旦大学附属中山医院青浦分院血液内科 　　 　　成人特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)是由血小板自身抗体所致的血小板减少为特征的自身免疫性疾病。近来,ITP的治疗取得了重要进展,欧美相继制定了ITP的诊断和治疗指南[1]。现将资料较完整的ITP临床案例进行分析,比较长春新碱联合糖皮质激素(VP)方案和大剂量丙种球蛋白(HDIVIG)治疗ITP患者的疗效,报告如下。 　　1 资料和方法 　　1.1 一般资料 2006年1月至2009年1月我院收治的ITP患者56例,均符合第10届全国血液学学术会议拟订的ITP诊断标准[2],排除继发性ITP;其中男25例,女31例;年龄20~60岁,中位年龄45岁;病