席壮新
XI Zhuangxin

• 1:苏州沧浪医院血液科

摘要(Abstract)：

目的:比较重组人血小板生成素(rh TPO)与人血丙种球蛋白治疗难治性血小板减少性紫癜的临床疗效。方法:选取难治性血小板减少性紫癜患者80例随机分为3组,rh TPO组皮下注射rh TPO,对照组予糖皮质激素治疗,人血丙球组在对照组治疗基础上给予人血丙种球蛋白;比较3组出血停止时间、血小板开始上升时间、血小板达正常时间、血小板升高达最高峰时间、停药后恢复到治疗前水平时间,观察3组患者疗效和不良反应。结果:rh TPO组、人血丙球组总有效率均高于对照组,差异有统计学意义(P<0.05),rh TPO组、人血丙球组总有效率差异无统计学意义(P>0.05);人血丙球组血小板开始上升时间、血小板达正常时间均短于rh TPO组,rh TPO组血小板升高达最高峰时间及停药后恢复到治疗前水平时间长于人血丙球组,差异具有统计学意义(P<0.05);rh TPO组与人血丙球组比较,不良反应发生率差异无统计学意义(P>0.05)。结论:rh TPO与人血丙种球蛋白均可有效治疗难治性血小板减少性紫癜,丙球起效更为快速,但rh TPO疗效更持久。
Objective: To investigate clinical efficacy of recombinant human thrombopoietin( rh TPO)and human γ-globulin treatment of refractory thrombocytopenic purpura. Methods: Eighty thrombocytopenic purpura patients were randomly divided into three groups,rh TPO group,human normal γ-globulin group and control group. rh TPO group accepted rh TPO,Human normal γ-globulin group received human γ-globulin on the basis of treatment in the control group,control group received glucocorticoid.The bleeding stop time,rise time of platelet,platelets back to normal time,platelet reached the peak time,and after stopping treatment platelet restoreing to the pre-treatment level time were compared.Treatment efficacy and adverse events were observed in the three groups. Results: The total effective rate of rh TPO group and human γ-globulin group were higher than control group,the difference was statistically significant( P < 0. 05); total effective rate between rh TPO group and human γ-globulin group had no significant difference( P > 0. 05); compared with human γ-globulin group,rise time of platelet and platelets back to normal time in rh TPO group were shorter,platelet reached the peak time and after stopping treatment platelet restoring to the pre-treatment level time was longer,the differences were statistically significant( P < 0. 05); comparing rh TPO group and human γ-globulin group,the incidences of adverse reactions had no significant difference( P > 0. 05). Conclusions: rh TPO and human gamma globulin may be effective in the treatment of refractory thrombocytopenic purpura,gamma globulin is faster,but rh TPO efficacy lasts longer.

关键词(KeyWords)： 血小板生成素;丙种球蛋白类;紫癜,血小板减少性;疗效
thrombopoietin;gamma-globulins;purpura,thrombocytopenic;curative efficacy

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 席壮新
XI Zhuangxin

DOI: 10.19367/j.cnki.1000-2707.2015.02.021

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