艾曲泊帕联合小剂量泼尼松治疗老年难治复发原发免疫性血小板减少症疗效观察

目的 观察艾曲泊帕联合小剂量泼尼松治疗老年难治复发原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)的疗效。方法 采用回顾性研究方法，分析52例60岁以上老年难治复发ITP患者的疗效，其中艾曲泊帕联合小剂量泼尼松治疗组(艾曲泊帕治疗组)23例，泼尼松联合免疫制剂(常规治疗组)29例。观察两组治疗前及治疗后1、2、4、8、12周血小板计数；治疗前及治疗后2周出血评分；治疗后4、8、12周有效率。结果 治疗第1周艾曲波帕治疗组血小板计数开始升高，此后血小板持续升高，第4周血小板计数为(109.18±77.81)×10⁹/L,且每一个观察截点均较前一观察截点有明显升高，差异具有统计学意义(P<0.05);常规治疗组治疗后血小板升高，但无持续升高趋势。两组出血积分治疗后分别为(2.91±1.92)分、(3.60±2.53)分，较治疗前[(7.64±3.77)分、(6.53±3.66)分]均有明显下降(P<0.05)。第8、12周艾曲波帕治疗组总有效率分别为87%、91.3%,与常规治疗组(55.2%、55.2%)相...

Curative effect of combination of eltrombopag and low-dose prednisone on refractory and relapsed primary immune thrombocytopenia in elderly patients

Objective To observe the efficacy of eltrombopag combined with low-dose prednisone in elderly patients with refractory and relapsed primary immune thrombocytopenia (ITP). Methods A retrospective analysis of the treatment efficacy of 52 elderly patients (over 60 years old) with refractory and recurrent ITP was performed. The patients were assigned to receive either eltrombopag+low-dose prednisone (the eltrombopag treatment group, n=23) or prednisone+immune stimulants (the conventional treatment group, n=29). The key observation was platelet count (PLC) on day 0 and on weeks 1, 2, 4, 8, 12, bleeding risk score on day 0 and on week 2, and effective rates on weeks 4, 8, 12. Results The PLC increased in the eltrombopag treatment group on week 1, thereafter, the platelets continued to rise, and PLC on week 4 was (109.18±77.81)×10⁹/L, moreover, each cut-off point was significantly higher than the previous cut-off point ( P<0.05). The platelets increased in the conventional treatment group, and with no continuous increasing trend. The bleeding risk score of the eltrombopag treatment group and the conventional treatment group after treatment was significantly lower than that before treatment ([2.91±1.92], [3.60±2.53] vs [7.64±3.77], [6.53±3.66], [ P<0.05], respectively). The overall effective rate on weeks 8, 12 in the eltrombopag treatment group was 87% and 91.3%, respectively, which in the conventional treatment group was 55.2% and 55.2%, respectively, and with statistically significant differences between groups ( P<0.05). Conclusion For elderly patients with refractory and recurrent ITP, eltrombopag combined with low-dose prednisone has good curative effect, and is worthy of selection application.