31例大剂量地塞米松治疗原发免疫性血小板减少紫癜的疗效观察.docVIP

精品论文 参考文献 31例大剂量地塞米松治疗原发免疫性血小板减少紫癜的疗效观察 （青海省人民医院血液风湿科，810000） 中图分类号 R558.2 文献标志码 A 文章编号 1008-0408（2015）2-0040-02 摘 要 目的：观察大剂量地塞米松治疗原发免疫性血小板减少紫癜的临床疗效。方法：我院2012年5月-2015年5月期间血液科收治的62例患者，随机分为对照组和治疗组每组患者各31例，对照组患者给予小剂量地塞米松长疗程治疗，治疗组患者给予大剂量地塞米松治疗，两组患者在治疗期间联合钙剂和质子泵抑制剂预防激素不良反应，治疗前根据患者出血严重程度给予输注血小板悬液，治疗无效的患者再给予其他免疫抑制剂，如长春新碱、美罗华、环孢素等。患者经治疗后评价治疗效果并记录用药期间的不良反应。结果：治疗组治愈率和总有效率均高于对照组，（Plt;0.05）具有统计学差异，治疗组患者的无效率明显低于对照组患者，（Plt;0.05）具有统计学差异。治疗组患者的不良反应发生率明显低于对照组患者，（Plt;0.05）具有统计学差异，两组患者均无消化道出血和股骨头坏死的不良反应发生，两组患者的不良反应在对症处理在药物减量后逐渐减轻，停药后不良反应自行消失。讨论：大剂量地塞米松治疗原发免疫性血小板减少紫癜的临床疗效确切，持续时间较长，不良反应较小，优于传统常规剂量的治疗方案，值得在临床中广泛推广。 关键词 大剂量地塞米松；原发免疫性血小板减少紫癜；临床疗效 Abstract objective to observe the high-dose dexamethasone in the treatment of primary immune thrombocytopenia purpura clinical curative effect. Methods from May 2012 to May 2015 of 62 patients admitted in onset, each group of patients were randomly divided into control group and treatment group 31 cases, control group patients give low-dose dexamethasone therapy treatment, the treatment group patients give high-dose dexamethasone treatment, two groups of patients during treatment in combination with calcium supplements and proton pump inhibitors prevent hormone adverse reactions, according to the patients before treatment hemorrhage severity given infusion platelet suspension, treatment is invalid to give other immune inhibitors, such as vincristine, mabthera, ring spore element, etc. Evaluate the effect of the treatment and after treatment in patients with record adverse reactions during medication. Results the treatment group cure rate and total effective rate were higher than the control group, (P lt; 0.05) statistically difference, the inefficiency of treatment group patients were significantly lower than the control group patients, (P lt; 0.05) statistically difference. Incidence of adverse reactions in patients with treatment group was obviously lower than the control group patients (P lt; 0.05) statistically differe