利妥昔单抗联合地塞米松治疗小儿难治性特发性血小板减少性紫癜临床效果观察

目的探讨应用利妥昔单抗(美罗华)联合地塞米松治疗儿童难治性特发性血小板减少性紫癜(RITP)的疗效及安全性。方法选择诊断为RITP的患儿22例,按照治疗方法不同分为对照组(大剂量地塞米松冲击治疗)和观察组(美罗华联合小剂量地塞米松治疗)。治疗结束后,对两组患儿进行疗效评价、观察记录药物不良反应,并应用流式细胞术测定11例观察组患儿治疗前后CD20+B细胞的数量变化。结果观察组临床疗效优于对照组,差异有显著性(P<0.05),治疗期间两组不良反应比较无明显差异,美罗华治疗后,有效组患儿外周血小板数量较治疗前明显升高,外周血CD20+B细胞数量较治疗前显著降低。结论美罗华联合地塞米松治疗RITP疗效确切,毒副作用较小。

Clinical effect of refractory idiopathic thrombocytopenic purpura treated by rituximab combined with dexamethasone in children

Objective To discuss the effect and safety of rituximab combined with dexamethasone in the treatment of children with refractory idiopathic thrombocytopenic purpura(RITP).Methods Twenty-two patients were diagnosed as RITP,which were divided into control group and observation group.The patients in control group were treated with high-dose dexamethasone,and those in the observation group were treated with low-dose dexamethasone combined with rituximab.The therapeutic effects and the drug adverse effects in two groups were observed respectively.Besides,the expressions of CD20+ B cells in peripheral blood were detected by flow cytometry in 11 patients before and after treatment.Results The effective rates of observation group was significantly higher than those in control group(P<0.05).There was no significant difference of the drug adverse effects between two groups.The platelet counts of the observation group after treatment was significantly higher than those before treatment.The expression of CD20+ B cell after treatment was significantly lower than those before treatment.Conclusion The treatment of RITP in children with rituximab combined with dexamethasone could result in better therapeutic effects and lower drug adverse effects.