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目的探讨环孢素A(CsA)治疗儿童难治性免疫性血小板减少性紫癜(RITP)的疗效及安全性。方法 RITP患儿47例分为两组:CsA组23例予CsA 5mg·kg~(-1)·d~(-1)分2次口服;长春新碱组24例,予长春新碱0.02mg/kg,静脉滴注8h,每周1次。两组治疗3个月后观察疗效及不良反应,并追踪随访复发情况。结果 CsA组有效率为78.26%(18/23),高于长春新碱组的37.50%(9/24)(P<0.01)。两组不良反应及随访复发情况均相仿(P>0.05)。CsA组有效治疗的患儿血小板计数升高,血小板相关免疫球蛋白降低,产血小板巨核细胞增加(P<0.01)。结论CsA治疗RITP患儿疗效明显,不良反应小。
Objective To investigate the efficacy and safety of cyclosporin A (CsA) in the treatment of childhood refractory immune thrombocytopenic purpura (RITP). Methods Totally 47 children with RITP were divided into two groups: CsA 5 mg · kg -1 · d ~ (-1) was given orally twice in 23 cases, vincristine 0.02 mg / kg, intravenous infusion of 8h, 1 times a week. After three months of treatment, the curative effect and adverse reactions were observed and follow-up of follow-up was observed. Results The effective rate was 78.26% (18/23) in CsA group and 37.50% (9/24) in vincristine group (P <0.01). Two groups of adverse reactions and follow-up were similar (P> 0.05). CsA group effectively treated children with elevated platelet count, platelet-associated immunoglobulin decreased platelet-producing megakaryocytes increased (P <0.01). Conclusion CsA treatment of children with RITP obvious curative effect, small adverse reactions.