Objective To explore the efficacy of second-line treatment with eltrombopag and rituximab in adult primary immune throm-bocytopenia(ITP).Methods A total of 80 adult ITP patients admitted to the Department of Hematology,Bozhou People's Hospital from May 2021 to March 2024 were prospectively selected as the research objects.They were divided into the control group and the experimental group ac-cording to the random number table method,with 40 cases in each group.The control group was given rituximab treatment,the dose was 100 mg and was administered intravenously once a week on days 1,8,15,and 22,continuous for 4 weeks.The experimental group was treated with el-trombopag on the basis of the control group,the initial dose was 25 to 50 mg per day of fasting oral administration,and the maximum dose was 75 mg per day according to the patient's condition,platelet count and drug instructions,continuous for 12 weeks.The therapeutic effect of the two groups was compared,the platelet counts before treatment,7 d,14 d,1 month and 3 months after treatment,and the percentage of peripheral blood regulatory T cells(Treg)and helper T cell 17(Th17)and Treg/Th17 levels were compared between the two groups before treatment and 3 months after treatment,the incidence of adverse reactions of the two groups were compared.Results The total effective rate of treatment in the ex-perimental group was 72.50％,which was higher than that in the control group(50.00％),and the difference was statistically significant(P＜0.05).At 7 d,14 d,1 month and 3 months after treatment,the platelet counts of the two groups were higher than those before treatment,and the platelet count of the experimental group at 3 months after treatment was(133.26±40.23)× 109/L,which was higher than that of the control group[(85.73±22.24)× 109/L],the differences were statistically significant(P＜0.05);there were no significant differences in platelet count between the experimental group and the control group at 7 days,14 days and 1 month after treatment(P＞0.05).The peripheral blood Treg and Treg/Th17 in the two groups at 3 months after treatment were higher than those before treatment,and the percentage of Th17 cells in the two groups was lower than that before treatment,the differences were statistically significant(P＜0.05).The peripheral blood Treg and Treg/Th17 in the experimental group at 3 months after treatment were(5.47±0.50)％and(3.42±0.36),respectively,which were higher than those in the control group[(5.06±0.49)％and 2.89±0.40],and the percentage of Th17 cells in the experimental group was(1.60±0.11)％,which was lower than that in the control group[(1.75±0.16)％],the differences were statistically significant(P＜0.05).There was no sig-nificant difference in the total incidence of adverse reactions between the control group(17.50％)and the experimental group(27.50％)(P＞0.05).Conclusion The efficacy of second-line treatment with eltrombopag and rituximab in adult primary immune thrombocytopenia is signifi-cant,which can improve the platelet count of patients,improve the immune regulation status of patients,and has good safety.
维普
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