目的 评估艾曲泊帕联合不同用药方案治疗成人原发免疫性血小板减少症(primary immune thrombocytopenia，ITP)的疗效及安全性。方法 根据入排标准，选取2018年1月—2022年12月本院血液内科收治的73例ITP患者作为研究对象进行回顾性分析，其中接受艾曲泊帕的患者为对照组19例，接受艾曲泊帕联合地塞米松治疗的患者39例，接受艾曲泊帕联合重组人血小板生成素(recombinant human thrombopoietin，rhTPO)治疗的患者15例。比较各组患者治疗前后的凝血功能、临床疗效和不良反应事件发生情况。结果 与本组治疗前相比，各组治疗后的血小板显著升高，而凝血酶原时间和活化部分凝血活酶时间均显著降低(P＜0。05);艾曲泊帕联合地塞米松组和艾曲泊帕联合rhTPO组的PLT显著高于对照组，而PT和APTT水平均显著低于对照组(P＜0。05);对照组总有效率为47。4%(9/19)，艾曲泊帕联合地塞米松组总有效率为89。7%(35/39)，艾曲泊帕联合rhTPO组总有效率为73。3%(11/15)。联合治疗组有效率均显著高于对照组;艾曲泊帕联合地塞米松组的总有效率显著高于艾曲泊帕联合rhTPO组(P＜0。05);各组总不良反应事件发生率的差异无统计学意义(P＞0。05)。结论 与单药相比较，艾曲泊帕联合用药的有效性显著提高，安全性没有显著差异，其中艾曲泊帕联合地塞米松有效率显著高于联合rhTOP。
Effect and Safety Comparison of Combination Therapy with Different Medication Scheme for Primary Immune Thrombocytopenia of Adults
Objective To evaluate effect and safety of combination therapy with different medication regimens for primary immune thrombocytopenia(ITP)of adults.Methods The paper reviewed and analyzed 73 patients with ITP admitted to Hematology Department of our hospital from January 2018 to December 2022 according to the inclusion criteria as study subjects.19 cases in control group were treated with treatment with itropopa,39 cases with itropopa combined with dexamethasone,and 15 cases with itropopa combined with recombinant human thrombopoietin(rhTPO).Coagulation function,clinical effect,and incidence of adverse reactions was compared before and after treatment.Results Platelet count in each group was significantly higher after treatment than before,prothrombin time and activated partial thromboplastin time was significantly less(P＜0.05).PLT levels of combination of itraconazole and dexamethasone,combination of itraconazole and rhTPO,were significantly higher than control group,PT and APTT levels were significantly lower than control group(P＜0.05).Total effective rate of control group was 47.4%(9/19),that of combination of itraconazole and dexamethasone group was 89.7%(35/39),that of combination of itraconazole and rhTPO group was 73.3%(11/15).Effective rate of combination therapy group were significantly higher than control group;Total effective rate of combination of itraconazole and dexamethasone group was significantly higher than combination of itraconazole and rhTPO group(P＜0.05).There was no statistically significant difference in overall incidence of adverse reactions among the groups(P＞0.05).Conclusion Combination therapy with itraconazole can achieve significantly higher effect than monotherapy,there is no significant difference in safety.Combination therapy with itraconazole and dexamethasone can achieve significantly higher effect than combination therapy with rhTOP.
AiqubopaPrimary immune thrombocytopenia of adultsDexamethasoneRecombinant human thrombopoietinSafety evaluation
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