摘要
目的研究小剂量美罗华治疗慢性特发性血小板减少性紫癜（idiopathicthrombocytopenicpurpura，ITP）的效果。方法2012年2月到2013年2月，安阳市人民医院共58例患者被确诊为慢性ITP。以数字法随机分成观察组（29例）和对照组（29例）。对照组给予地塞米松，40mg／d，静脉滴注，连续4d，观察组给予小剂量美罗华100mg／次，静脉滴注，1次／周，连续治疗4周。观察两组血小板计数（PLT）、血小板抗体水平以及治疗前后的免疫细胞水平。结果观察组总有效率为65．52％（19／29），显著高于对照组[37．93％（11／29）]，差异有统计学意义（P〈0．05）。观察组治疗后PAIgG水平为（50．15±49．91）ng／10^7，显著低于治疗前（133．04±117．69）ng／10＆7，以及对照组治疗后（77．23±50．11）ng／10^7血小板。观察组治疗后PLT水平为（72．13±0．42）×10^9／L，显著高于治疗前[（9．32±0．57）×10^9／L]，以及对照组治疗后[（48．56±0．63）×10^9／L]。观察组治疗后CD19＋CD20＋为107±89，显著少于治疗前的368±274，以及对照组治疗后的241±143；观察组治疗后CD4＋CD25＋FOXP3-为（6．5±4．2）％，显著少于治疗之前[（10．4±9．3）％]，以及对照组治疗后[（8．8±4．3）％]。差异均有统计学意义（P均〈0．05）。结论以小剂量美罗华对慢性ITP进行治疗，可明显减少血小板有关抗体，改善免疫细胞功能，提高血小板水平，疗效明显，值得临床推荐。
Objective To study the effect of small doses of rituximab on chronic idiopathic thrombocytopenic purpura（ITP）. Methods From February 2012 to February 2013, in the People＇ s Hospital of Anyang, a total of 58 patients were diagnosed as chronic ITP. They were randomly divided in- to the observation group（29 cases） and the control group （29 cases）, the patients in the control group were treated with dexamethasone, 40 mg/d, intravenous drip, lasted for 4 d, while the patients in the observation group were treated with small doses of rituximab, 100 mg/times, intravenous drip, 1 time/week, lasted for 4 weeks. The effects on platelet recovery, platelet antibody levels as well as the level of immune cells were observed. Results The total effective rate was 65.52% （19/29） in the ob- servation group, which was significantly higher than that in the control group 37.93% （11/29） . There were significant differences （ P 〈 0. 05 ）. The PAIgG level in the observation group after treatment was （50. 15 ± 49.91 ）ng/107, which was significantly lower than that before treatment （133.04 ± 117.69）ng/107 PAL, and that in the control group after treatment （77.23 ±50. 11 ）ng/107 PAL. The PLT level in the observation group after treatment was （72. 13 ±0. 42） ×109/L, which was significantly lower than that before treatment （9.32 ± 0.57） x 109/L l, and the control group after treatment （48.56 ± 0. 63 ） × 109/L. After treatment, CD19＋CD20 ＋ was 107 ± 89 in the observation group, which was significantly less than that before treatment （368 ± 274）, and that in the control group after treatment （241 ± 143）; CD4 ＋ CD25 ± FOXP3-was 6. 5 ±4.2 in the observation group after treatment, which was significantly lower than that before treatment （ 10.4 ± 9.3 ）, and that in the control group after treatment （8.8 ± 4. 3 ）. There were significant differences （ Pall 〈 0. 05 ）. Conclusions Small dose of rituximab in the treatment of chronic ITP, can significantly reduce platelet related antibodies, improve patients＇ immune cell function and elevate the level of platelet, which has good efficacy and is worthy of clinical recommendation.
出处
《中国实用医刊》
2014年第9期7-9,共3页
Chinese Journal of Practical Medicine
