摘要
目的：观察大剂量地塞米松、常规剂量泼尼松两种方案治疗初诊免疫性血小板减少性紫癜（ITP）的临床疗效和不良反应.方法：45例初诊ITP分为两组,治疗组20例,地塞米松40 mg/d,静脉滴注,连用4d;对照组25例,泼尼松1 mg·kg^-1 ·d^-1,晨起顿服,3～4周后若血小板稳定,则开始减量,减量至10 mg/d时维持治疗4～6个月.结果：治疗后第4天治疗组与对照组血小板计数值为（35±18.2）×10^9/L和（16 ±6.4）×10^9/L,两组比较差异有统计学意义（P＜0.05）;治疗组和对照组总有效率分别为85％和76％,两组差异无统计学意义（P＞0.05）;长期反应率分别为52.6％和31.8％,两组比较差异有统计学意义（P＜0.05）;对照组所有病例皆出现不同程度类库欣氏表现;2例继发血糖升高;3例继发感染.治疗组不良反应较对照组明显减轻.结论：大剂量地塞米松治疗初诊ITP血小板上升速度快,长期反应率高,不良反应小,可作为临床一线方案.
Objective： To observe the clinical effect and untoward effect of high - dose dexamethasone and conventional prednisone for immunologic thrombocytopenic purpura （ITP） . Methods： Forty -five patients with newly diagnosed ITP were divided into two groups, treatment group 20 cases, dexamethasone 40 mg/d, continuous 4 d ; control group 25 patients, prednisone 1 mg · kg^-1 · d^-1. Results：The first 4 days after treatment,platelet count were （35 ± 18.2） × 10^9/L and （ 16 ±6.4） × 10^9/L in two groups, there was significient difference（ P 〈 0.05 ）. The total effective rate was 85% and 76% in treatment group and control group respectively and there is no significant difference between these two groups （ P 〉 0.05 ）. The long - term response rates were 52.6 % and 31.8% in treatment group and control group respectively and there is a significant difference between these two groups. All patients in the control group were welcomed with varying degrees library＇s performance;2 cases secondary to hyperglycemia;3 cases of secondary infection. Compared with the control group, side effects was mild in treatment group. Conclusion：High - dose dexamethasone might be use as first - line method to treat the newly diagnosed ITP. The longterm response rates is high, adverse reactions is small, can be used as first- line clinical program.
出处
《临床医药实践》
2014年第11期815-817,共3页
Proceeding of Clinical Medicine
作者简介
杜舟（1984-）,男,安徽省合肥市人,学士学位,医师,主要从事血液病临床治疗工作.
