【摘要】 目的:探讨原发性免疫性血小板减少症(PITP)采用大剂量地塞米松治疗后的临床疗效。方法:选取2013年1月至2015年6月本院收治的原发性免疫性血小板减少症患者70例,采用随机平均数字分配法将70例患者分为A组(35例)、B组(35例),A组使用大剂量地塞米松40 mg/d,静脉滴注连续冲击治疗4 d为1个疗程;B组使用泼尼松1 mg·kg-1·d-1,给药途径为口服,连续用药4周为1个疗程。对比A、B两组患者的血小板数变化情况。结果:治疗第5天后,A组的显效率、总有效率均高于B组,组间比较,差异具有统计学意义(P<0.05)。治疗4 d、7 d期间,A组患者不良反应发生率为2.9%。B组患者不良反应发生率为14.3%,组间比较,差异具有统计学意义(P<0.05)。结论:采用大剂量地塞米松治疗PITP起效快、安全性好、不良发应发生率小,适合短期冲击治疗。更多还原

【Abstract】 Objective To investigate the clinical effect of high dose dexamethasone(PITP) in the treatment of primary immune thrombocytopenia. Methods A total of 70 cases from 2013 January to 2015 June in our hospital from primary immune platelet in patients with thrombocytopenia, the stochastic average digital distribution will be 70 cases of patients were randomly divided into group A(n = 35), group B(n = 35). In group A were treated with 40 mg /d of large dose of dexamethasone, vein drop note continuous shock treatment for 4 days for a course of treatment; group B using poured prednisone mg·kg-1·d-1, route of administration is oral, continuous medication for 4 weeks for a course of treatment. The changes of platelet count in two groups of patients with A and B were compared. Results Fifth days after treatment, A group, markedly effective in 57.1% cases, accounting for 20 of the total, 7 cases, accounting for 20 % of the total, 6 cases, accounting for 17.1 % of the total, 2 cases, accounting for 5.7% of the total. The total effective rate was 94.3 % after treatment in the A group. In B group, 3 cases were markedly effective, accounting for 8.6% of the total, 10 cases, accounting for 28.6 % of the total, 15 cases, accounting for 20% of the total, 7 cases ineffective, accounting for 20% of the total. The total effective rate in the B group was 80 %. The total effective rate of A group was significantly higher than that in B group, and the difference between the groups was statistically significant(P<0.05). A group of patients with 7d, 4d, 1 cases of water and sodium retention, no blood pressure and blood glucose, electrolyte disorders and serious infection and other adverse reactions, adverse reaction rate was 2.9%. In the B group, 14.3% patients had nausea, vomiting, blood pressure and adverse reaction, the incidence of adverse reactions was 5, the difference between the groups was obvious(P<0.05). Conclusion high dose dexamethasone in the treatment of PITP is effective and safe, and the incidence of adverse reactions is small, which is suitable for short-term impact.更多还原