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作者为阐明小剂量类皮质激素疗法在急性ITP治疗中的作用,对160例儿童、223例成人ITP患者进行了随机临床试验来比较常规剂量(1mg/kg/日)与小剂量(0.25mg/kg/日)的类皮质激素疗法对急性ITP的疗效。在治疗前病人均未接受过类皮质激素治疗或其它对免疫性疾病有作用的药物(如免疫抑制剂)。随机分配病人接受3周的类固醇治疗(强的松或强的松龙1mg/kg/日或0.25mg/kg/日),并在第4周内逐渐停药。此后,若病人出血与血小板下降仍继续存在,再接受与第1疗程剂量相同的第2疗程,倘若0.25mg/kg/日的剂量被证明无效,小剂量组的病人再给予常规量治疗。对成人治疗后的第6-9个月、儿童第12-15个月期间内血像进行疗效评价,BPC
To clarify the role of low dose corticosteroid therapy in the treatment of acute ITP, a randomized clinical trial of 160 children and 223 adults with ITP was performed to compare the effects of conventional (1 mg / kg / day) and low dose (0.25 mg / kg / day) of corticosteroid therapy for acute ITP. None of the patients had been treated with corticosteroids or other drugs (such as immunosuppressants) that had an effect on immune diseases before treatment. Patients were randomized to receive 3 weeks of steroid treatment (prednisone or prednisolone 1 mg / kg / day or 0.25 mg / kg / day) and gradually discontinued at week 4. Thereafter, if the patient’s bleeding and thrombocytopenia persist, and then receive the same course of treatment as the first two courses of treatment, if the dose of 0.25mg / kg / day proved ineffective, low-dose group of patients given conventional therapy. After the adult treatment of 6-9 months, children during the first 12-15 months to evaluate the effect of blood, BPC