难治性特发性血小板减少性紫癜的治疗进展-医学信息.PDF

述 学信息2018 年3 月第31 卷第5 期 Medical Information. Mar. 2018. Vol. 31. No.5 难治性特发性血小板减少性紫癜的治疗进展 唐培渊 宋俊峰 秦克乐 王 寻 阎 雄 渊重庆医科大学附属第一医院肝胆外科 重庆 400010冤 摘 要 特发性血小板减少性紫癜经脾切除和糖皮质激素治疗后仍需积极治疗定义为难治性特发性血小板减少性紫癜遥目前糖 皮质激素尧免疫球蛋白尧艾曲波帕尧罗米司亭尧利妥昔单等已广泛应用于该病的治疗 但部分患者仍无疗效 进 有更多新型药 物正在研发 如新型促血小板药物Avatrombopag 渊E5501冤尧抗CD20 单克隆抗体渊Veltuzumab冤尧Syk 抑制剂渊R788冤尧抗CD152 抗 体渊Alemtuzumab冤等 或者免疫抑制剂用于该病 如长春花碱尧环孢素A尧环磷酰胺等遥也有针对于该病的新理论的提出需要临床 验证遥 本文就围绕该病的治疗进展展开讨论遥 关键词 难治性特发性血小板减少性紫癜曰糖皮质激素曰免疫球蛋白曰副脾切除 中图分类号 R554.6 文献标识码 A DOI 10.3969/j .issn.1006-1959.2018.05.016 文章编号 1006-1959渊2018冤05-0042-05 Progress in Treatment of Refractory Idiopathic Thrombocytopenic Purpura TANG Pei-yuan,SONG Jun-feng,QIN Ke-le,WANG Xun,YAN Xiong (Department of Hepatobiliary Surgery,First Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China) Abstract Idiopathic thrombocytopenic purpura is still defined as refractory idiopathic thrombocytopenic purpura after splenectomy and glucocorticoid therapy.At present,glucocorticoids,immunoglobulin,atropa,romistin,rituximab and so on have been widely used in the treatment of the disease,but some patients still have no effect,and more new drugs are being developed.For example,a new platelet-stimulating drug named Avatrombopaga (E5501),a monoclonal antibody against CD20 (Veltuzumab),Syk inhibitor(R788),anti CD152 antibody (Alemtuzumabis),or immunosuppressive agents for the disease,such as vinorelbine,cyclosporine A,cyclophosphamide, etc.There is also a need for clinical verification of new theories on the disease.This paper discusses the progress in the treatment of the disease. Key words Refractory idiopathic thrombocytopenic purpura;Glucocorticoid;Immunoglobulin;Accessory splenectomy 特发性血小板减少性紫癜（immune thrombocy 于难治性ITP ，如环孢菌素、吗替麦考酚