不同周期大剂量地塞米松对初诊ITP的疗效和安全性分析

doi:10.12047/j.cjap.5673.2018.099

中国应用生理学杂志 ›› 2018, Vol. 34 ›› Issue (5): 436-440.doi: 10.12047/j.cjap.5673.2018.099

不同周期大剂量地塞米松对初诊ITP的疗效和安全性分析

肖悦, 李唐菲

重庆医科大学附属永川医院血液内科, 重庆 402160

收稿日期:2018-01-23 修回日期:2018-09-25 出版日期:2018-09-28 发布日期:2019-02-21
通讯作者: 李唐菲,Tel:023-85368411;E-mail:48342079@qq.com E-mail:48342079@qq.com
基金资助:
重庆市卫生计生委2015年医学科研计划项目（2015ZBXM070）

Analysis of high-dose dexamethasone in different cycles on efficacy and safety of newly diagnosed ITP

XIAO Yue, LI Tang-fei

Yongchuan Affiliated Hospital, Chongqing Medical University, Chongqing 402160, China

Received:2018-01-23 Revised:2018-09-25 Online:2018-09-28 Published:2019-02-21
Supported by:
重庆市卫生计生委2015年医学科研计划项目（2015ZBXM070）

摘要/Abstract

摘要： 目的：比较单周期、双周期、三周期大剂量地塞米松治疗初诊原发免疫性血小板减少症（ITP）的疗效和安全性。方法：93名初诊患者按1∶1∶1随机接受单周期（A组：地塞米松每次40 mg每天1次，第1日至第4日）、双周期（B组：地塞米松每次40 mg每天1次，第1日至第4日、第15日至第18日）、三周期大剂量地塞米松（C组：地塞米松每次40 mg每天1次，第1日至第4日、第15日至第18日、第29日至第32日）治疗，比较三组患者的疗效和安全性。结果：93名初诊原发免疫性血小板减少症患者，A组、B组、C组各31名患者，就短期疗效而言，三组相比，停药第7日完全反应率、第14日完全反应率差异均无统计学意义，但是，停药第7日ABC三组的有效率（41.9%vs 70.0%vs 90.0%，P<0.01）、第14日有效率（16.1%vs 36.70%vs 63.3%，P<0.01）差异有统计学意义；就长期疗效而言，三组之间治疗第120日有效率、第60日完全反应率、第90日完全反应率、第120日完全反应率、第90日复发率、第120日复发率差异无统计学意义，但是，第60日有效率（10.0%vs 26.6%vs 53.3%，P<0.01）、第90日有效率（0.0%vs 13.3%vs 30.0%，P<0.01）和第60日复发率（88.9.0%vs 73.3%vs 46.7%，P<0.01）差异有统计学意义，三组治疗相关的不良反应多较轻微，患者大多可耐受。结论：增加大剂量地塞米松的周期，虽没有提高ITP患者的完全反应率，但提高了3月内的有效率，且不良反应可以耐受，可以作为临床用药的参考。

关键词: 血小板减少, 原发性, 地塞米松, 疗效, 安全性

Abstract: Objective: To compare the efficacy and safety of high-dose dexamethasone in treating new-diagnosed primary immune thrombocytopenia (ITP) in monocycle, di-cycle, tri-cycle. Methods: Divided by the ratio of 1:1:1, 93 newly diagnosed patients were randomly accepted monocycle (Group A:dexamethasone 40 mg once a day, from day1 to day4), dicycle (Group B:dexamethasone 40 mg once a day, from day 1 to day 4, day 15 to day 18), tri-cycle (Group C:dexamethasone 40 mg once a day, from day 1 to day 4, day 15 to day 18, day 29 to day 32) of high-dose dexamethasone treatment. Its efficacy and safety on the patients in three groups were compared. Results: Ninety-three newly patients with new-diagnosed ITP were divided into Group A, B, and C, 31 patients in each group. In terms of short-term benefits, there was no statistically significant difference among the 7th and 14th day complete response rate after end of treatment. However, there was statistically significant difference after the end of treatment on the 7th day response rate (41.9% vs 70.0% vs 90.0%, P<0.01) and the 14th day response rate (16.1% vs 36.70% vs 63.3%, P< 0.01); in terms of long-term benefits, there was no statistically significant difference among the 120-day response rate, the complete response rate within the treatment on the 60th, 90th and 120th day and the relapse rate at 90th and 120th day; however, there was statistically significant difference among the 60- day response rate (10.0% vs 26.6% vs 53.3%, P<0.01), 90-day(0.0% vs 13.3% vs 30.0%, P<0.01) and 60-day relapse rate(88.9% vs 73.3% vs 46.7%, P<0.01). Mostly of the treatment-related adverse reactions in the three groups were mild, and most patients are tolerable. Conclusion: Although the complete response rate of ITP patients did not improved by increasing the cycle of high-dose dexamethasone, but improved response rate in three months, and adverse reactions were tolerable, which could be used as a reference for clinical use.

Key words: thrombocytopenia, primary, dexamethasone, efficacy, safety

肖悦, 李唐菲. 不同周期大剂量地塞米松对初诊ITP的疗效和安全性分析[J]. 中国应用生理学杂志, 2018, 34(5): 436-440.

XIAO Yue, LI Tang-fei. Analysis of high-dose dexamethasone in different cycles on efficacy and safety of newly diagnosed ITP[J]. CJAP, 2018, 34(5): 436-440.

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不同周期大剂量地塞米松对初诊ITP的疗效和安全性分析

Analysis of high-dose dexamethasone in different cycles on efficacy and safety of newly diagnosed ITP

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