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.doc

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1、小剂量利妥昔单抗治疗难治性血小板减少性紫瘢的临床研究［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瘢的临床疗效。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瘢患者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/ni2,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

2、有统计学意义（P<0.05）o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）o结论小剂量的利妥昔单抗治疗难治性血小板减少性紫瘢效果明显，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瘢；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）19-64-03ClinicalObservationofSmallDoseMabtheraTherapyforTntractableIdiopathicThrombocytop

3、enicPurpuraCHENDongPEIRenzhiZHANGPishengMAJunxiaDepartmentofHematology,YinzhouPeople'sHospitalofNingboCityinZhejiangProvince,Ningbo315040,China[Abstract]ObjectiveToobservetheclinicaleffectofintractableidiopathicthrombocytopenicpurpuratreatedbysmalldosemabthera.MethodsRetrospe

4、ctiveanalysisofthepatientsfromJan.2008toDec.2010inourhospital.Atotalof34patientswithintractableidiopathicthrombocytopenicpurpurawererandomlydividedintosmalldosegroupandlargedosegroup.Thepatientsofsmalldosegroupweretreatedbymabthera100mg/m2for4weeksandthepatientsoflargedosegro

5、upweretreatedbymabthera375mg/m2.Bloodroutinewasdetectedbeforeandaftermedicationforonceaweek.Tocomparethechangeofserumimmuneglobulinandplateletcount.ResultsThechangeofplateletcountforbeforeandaftertreatmentwassignificant!}^different(P<0.05).Thesagittaldiameterofspinalcanalforb

6、eforecomparedtothelengthafterlaminectomywasstatisticalsignificantlydifferent(P<0.05).Thesagittaldiameterofedgeordegenerativecervicalbodyforbeforecomparedtothelengthafterlaminectomywasnotsignificantlydifferent(P>0.05).Theclinicaleffectsforsmalldosegroupandlargedosegroupweresig

7、nificantlydifferent(P<0.05).Theoverallresponserateofthesmalldosegroupwas94.12%andlargedosegroupwas58.82%.Theoverallresponseratesoftwogroupswerestatisticallydifferentsignificantly(P<0.05).ConclusionTheclinicaleffectofsmal1dosemabtheratherapyforintractableidiopathicthrombocytop

8、enicpurpuraissignificantanditisworthyofclinicalpopularizingandapplic