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目的观察重组人血小板生成素(rhTPO)治疗慢性难治性免疫性血小板减少性紫癜(ITP)的疗效,探讨骨髓巨核细胞数与疗效的关系。方法 21例慢性难治性ITP患者,予皮下注射rhTPO,15 000 U.d-1,每日1次,疗程14 d。动态观察患者血常规,定期监测肝、肾功能及凝血功能,并分析治疗有效患者骨髓巨核细胞数与血小板上升数值之间的相关性。结果 21例患者用药前血小板计数为(12±s 7)×109.L-1,用药后d 8血小板计数上升至(42±5)×109.L-1,与用药前比较差异非常显著(P<0.01),血小板计数最高值为(102±103)×109.L-1,有效率为76%。rhTPO治疗有效患者骨髓巨核细胞数与血小板上升数值呈正相关(r=0.692,P=0.003)。仅1例出现轻微不良反应。结论 rhTPO治疗慢性难治性ITP起效快,短期疗效、安全性好,骨髓巨核细胞数越多的患者疗效越显著。
Objective To observe the therapeutic effect of recombinant human thrombopoietin (rhTPO) on chronic refractory immune thrombocytopenic purpura (ITP) and to explore the relationship between the number of bone marrow megakaryocytes and the therapeutic effect. Methods Twenty-one patients with chronic refractory ITP were injected subcutaneously with rhTPO at 15 000 U.d-1 once daily for 14 days. Dynamic observation of patients with blood, regular monitoring of liver and renal function and coagulation, and analysis of the effective treatment of patients with bone marrow megakaryocyte number and platelet rise correlation between value. Results Twenty-one patients had a platelet count of (12 ± s 7) × 109.L-1 before treatment, and d 8 platelet count increased to (42 ± 5) × 109.L-1 after treatment, which was significantly different from that before treatment P <0.01). The highest platelet count was (102 ± 103) × 109.L-1, with an effective rate of 76%. The number of bone marrow megakaryocytes in rhTPO-treated patients was positively correlated with platelet rise (r = 0.692, P = 0.003). Only one case showed mild adverse reactions. Conclusion RhTPO treatment of chronic refractory ITP rapid onset, short-term efficacy, good safety, the greater the number of bone marrow megakaryocytes in patients with significant effect.