肾上腺糖皮质激素联合小剂量利妥昔单抗治疗新诊断的原发性免疫性血小板减少症疗效观察..docVIP

肾上腺糖皮质激素联合小剂量利妥昔单抗治疗新诊断的原发性免疫性血小板减少症疗效观察 于俊杰 华敏 杨左光 铉立国 作者单位 122000 辽宁省朝阳市第二医院血液科 by adrenal glucocorticoids in combination with small dose of rituxan regimen. Yu Junjie, Hua Min, Yang Zuoguang, Xuan Liguo Department of Hematology, The second hospital of Chaoyang, Liaoning, China 122000 【摘要】目的 观察比较肾上腺糖皮质激素联合小剂量利妥昔单抗方案与肾上腺糖皮质激素方案治疗新诊断的原发性免疫性血小板减少症(ITP)的疗效。方法 64例新诊断的ITP患者，男25例、女39例，中位年龄31(18～70)岁。随机分为①对照组(31例)：泼尼松：1．0mg/kg·d开始口服，一般疗程3-6个月；②试验组(33例)：利妥昔单抗100 mg /w,静脉滴注，连用4 次; 同时给予肾上腺糖皮质激素治疗用法同对照组一致。。观察比较两组患者的近、远期疗效和不良反应情况。结果 两组患者治疗后第4周的总缓解(OR)率分别81.28％对67.74％，P0.05;第12周的OR率分别为66.67％对41.94％，P0.05；第 6月的OR率分别为63.64％对35.48％，P0.05；第12 月的OR率分别为60.61％对32.26％，P0.05。第3月、第4月和第12月的OR率差异有统计学意义，试验组患者OR率明显高于对照组。两组患者不良反应均能耐受。结论 肾上腺糖皮质激素联合小剂量利妥昔单抗治疗新诊断的原发性免疫性血小板减少症缓解率优于肾上腺糖皮质激素方案。 【关键词】血小板减少症，免疫性；单克隆抗体，CD20； 肾上腺糖皮质激素 [Abstract] Purpose To observe and compare the curative effect of treating the newly diagnosed primary immune thrombocytopenia(ITP) between adrenal glucocorticoids in combination with small dose of rituxan regimen with adrenal regimen. Methods 64 newly diagnosed ITP patients, including 25 male, 39 female. And the median age is 31 (18 ~ 70). It is randomly divided into (1) control group(31 cases): Prednison 1.0mg/kg·d: Starts to take it orally, and general course is 3-6 months. (2) experimental group (33 cases) : rituxan 100 mg/w, intravenous drip, stay on four times; at the same time giving adrenal glucocorticoid treatment which usage is in accord with the control group. Then observe and compare of the long-term curative effect, short-term curative effect and the adverse reactions of the two groups of patients. Consequence In the 4th week after treatment, the OR rate of patients in 2 groups is 81.28% to 67.74% respectively, P 0.05; in the 3th month it is 66.67% to 41.94% respectively, P 0.05; in the 6th month it is 63.64% to 35.48% respectively, P 0.05; in the 12th month OR rate is 60.61% to 32.26% respectively, P 0.05. The difference of the OR rate in t