霉酚酸酯治疗激素无效成人免疫性血小板减少症的临床研究

王敏; 冯非儿; 王谦明; 赵婷; 付海霞; 江倩; 江浩; 路瑾; 许兰平; 张晓辉

doi:10.13201/j.issn.1004-2806.2016.03.005

霉酚酸酯治疗激素无效成人免疫性血小板减少症的临床研究

- 北京大学人民医院, 北京大学血液病研究所(北京, 100044)
基金项目:
国家自然科学基金(No:81470343)

国家自然科学基金(No:81270643)

详细信息

通讯作者: 张晓辉,E-mail:zhangxh100@sina.com

中图分类号: R558.2

收稿日期: 2015-11-16

Outcome of corticosteroid-resistant adult immune thrombocytopenia treated with mycophenolate mofetil

- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China

More Information

Corresponding author: ZHANG Xiaohui, E-mail: zhangxh100@sina.com

Received Date: 16 November 2015

摘要

摘要: 目的: 探讨以霉酚酸酯(MMF)为主的方案治疗激素无效的成人免疫性血小板减少症(ITP)的疗效和安全性。方法: 回顾性分析23例服用MMF(1.0~2.0 g/d)治疗的激素无效成人ITP患者,观察疗效及毒副作用。结果: MMF治疗的总体有效率为73.9%(17/23),其中6例(35.3%)完全缓解,11例(64.7%)部分缓解。MMF治疗中位起效时间为27(20~35) d,血小板计数升至峰值的中位时间为69(49~95) d。MMF治疗后,14例(82.4%)患者持续有效,随访时间为15.0(8.5~30.5)个月。MMF治疗有效患者的ITP病程明显短于MMF治疗无效患者的病程(P<0.05);MMF联合激素、环孢素或达那唑治疗的起效时间,明显短于MMF单药治疗的起效时间(P<0.05)。23例患者服用MMF期间未发生严重并发症。结论: MMF对于激素无效的成人ITP有较好的疗效,且毒副作用小。
- 霉酚酸酯 /
- 糖皮质激素 /
- 免疫性血小板减少症
Abstract: Objective: To evaluate the efficacy and safety of mycophenolate mofetil (MMF) in the treatment of corticosteroid-resistant adult immune thrombocytopenia (ITP).Method: The efficacy and toxicity of MMF (1.0 to 2.0 g/d) in the treatment of 23 corticosteroid-resistant adult ITP patients were retrospectively analyzed.Result: The overall response rate was 73.9% (17/23).Six (35.3%) patients achieved a complete response and 11 (64.7%) patients achieved a partial response.The median time to response was 27 (20 to 35) days.Peak platelet count was noted on a median of 69 (49 to 95) days.Fourteen (82.4%) patients sustained response after a median follow-up of 15.0 (8.5 to 30.5) months.Patients who responded to MMF therapy had a shorter disease history than those who had no response (P<0.05).Patients treated with therapy combining MMF with corticosteroid,cyclosporine or danazol responded earlier than patients treated with MMF single therapy (P<0.05).No patients experienced severe complications during follow-up.Conclusion: MMF is effective for corticosteroid-resistant adult ITP patients with minor toxicity.
- mycophenolate mofetil /
- corticosteroid /
- immune thrombocytopenia

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