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脾切除和使用糖皮质激素是治疗原发性血小板减少性紫癜的两种主要方法。脾切除的临床治愈率达70%以上。糖皮质激素可引起巨噬细胞功能障碍,并最终减少抗体的产生,但通常因需长期治疗而导致不良副作用。以上两法能使约3/4的患者获临床控制,其余为顽固型。此型患者约有15～30%可用硫唑嘌呤或环磷酰胺(或两药联用)治疗而获良好效果,但疗效缓慢,且常有骨髓中毒的危险。其它药物,如放线菌素D、苯丁酸氮芥、氨甲喋呤、门冬酰胺酶等,效果一般不佳。作者对上述顽固型患者用长春新碱进行深入研
Splenectomy and the use of glucocorticoids are the two main treatments for idiopathic thrombocytopenic purpura. The clinical cure rate of splenectomy is more than 70%. Glucocorticoids cause macrophage dysfunction and ultimately decrease antibody production, but often lead to undesirable side effects due to long-term treatment. The above two methods can make about 3/4 of patients under clinical control, the rest are stubborn. About 15 to 30% of this type of patients can be treated with azathioprine or cyclophosphamide (or a combination of both drugs) and good results, but the effect is slow, and often the risk of bone marrow poisoning. Other drugs, such as actinomycin D, chlorambucil, methotrexate, asparaginase, the general effect is not good. The author of the stubborn patients with vincristine for further study