小剂量利妥昔单抗治疗难治性血小板减少性紫癜的临床研究
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[摘要] 目的 研究小剂量利妥昔单抗治疗难治性血小板减少性紫癜的临床疗效。方法 选自我院2008年1月～2010年12月收治的难治性血小板减少性紫癜患者34例，均分为小剂量组及常规剂量组，其中小剂量组选择使用利妥昔单抗100mg/m2，连续使用4周，常规剂量组使用剂量为375mg/m2，患者治疗前后每周均检测血常规2次，测定血清免疫球蛋白量及血小板数量等进行疗效评估，并进行统计学分析。结果 小剂量组与常规剂量组治疗后血小板数与治疗前比较，差异均有统计学意义；小剂量组治疗后与大剂量组治疗后效果对比，差异有统计学意义(P<0.05)。小剂量组患者有效率为94.12%，大剂量组患者有效率为58.82%，两组有效率比较差异有统计学意义(P<0.05)。结论 小剂量的利妥昔单抗治疗难治性血小板减少性紫癜效果明显，并发症少，值得临床进一步推广。
[关键词] 利妥昔单抗；难治性血小板减少性紫癜；免疫球蛋白
[中图分类号] R554.6 [文献标识码] B[文章编号] 1673-9701(2011)19-64-03
Clinical Observation of Small Dose Mabthera Therapy for Intractable Idiopathic Thrombocytopenic Purpura
CHEN DongPEI RenzhiZHANG PishengMA Junxia
Department of Hematology, Yinzhou People’s Hospital of Ningbo City in Zhejiang Province, Ningbo 315040, China
[Abstract] Objective To observe the clinical effect of intractable idiopathic thrombocytopenic purpura treated by small dose mabthera. Methods Retrospective analysis of the patients from Jan. 2008 to Dec. 2010 in our hospital. A total of 34 patients with intractable idiopathic thrombocytopenic purpura were randomly divided into small dose group and large dose group. The patients of small dose group were treated by mabthera 100mg/m2 for 4 weeks and the patients of large dose group were treated by mabthera 375mg/m2. Blood routine was detected before and after medication for once a week. To compare the change of serum immune globulin and platelet count. Results The change of platelet count for before and after treatment was significantly different (P<0.05). The sagittal diameter of spinal canal for before compared to the length after laminectomy was statistical significantly different (P<0.05). The sagittal diameter of edge or degenerative cervical body for before compared to the length after laminectomy was not significantly different (P>0.05). The clinical effects for small dose group and large dose group were significantly different (P<0.05). The overall response rate of the small dose group was 94 ......
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