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目的探讨霉酚酸酯(MMF)治疗小儿难治性特发性血小板减少性紫癜(RITP)的临床疗效。方法选择2006年6月-2009年3月本院儿科血液门诊和病房诊治的RITP患儿10例,应用MMF进行治疗,MMF剂量为20~25 mg.kg-1.d-1,分2次间隔12 h口服,疗程3个月,有效者原剂量继续服用3~6个月,以后逐渐减量维持。结果显效2例,良效3例,进步2例,无效3例,总有效率80%。不良反应主要为可耐受的消化道症状2例,表现为恶心、呕吐、腹痛、腹泻症状;白细胞轻度减少1例及2例机会感染,表现为上呼吸道感染。结论MMF对小儿RITP疗效良好,不良反应轻,临床应用安全有效。
Objective To investigate the clinical efficacy of mycophenolate mofetil (MMF) in the treatment of refractory idiopathic thrombocytopenic purpura (RITP) in children. Methods Ten patients with RITP in pediatric blood clinic and ward of our hospital from June 2006 to March 2009 were treated with MMF. The MMF dose was 20-25 mg.kg-1.d-1, Interval of 12 h oral medication for 3 months, the effective dose of the original continue to take 3 to 6 months after the gradual reduction of maintenance. Results in 2 cases markedly effective in 3 cases, improved in 2 cases, 3 cases, the total effective rate was 80%. Adverse reactions were mainly 2 cases of tolerable gastrointestinal symptoms, manifested as nausea, vomiting, abdominal pain, diarrhea symptoms; white blood cells decreased slightly in 1 case and 2 cases of opportunistic infections, manifested as upper respiratory tract infection. Conclusion MMF has a good effect on pediatric RITP with mild adverse reactions and is safe and effective in clinical application.