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目的评价重组人血小板生成素(rhTPO)联合静脉注射免疫球蛋白治疗儿童难治性ITP的临床疗效。方法对18例儿童难治性重型ITP进行rhTPO联合静脉注射免疫球蛋白治疗,rhTPO给予每次300U/kg,皮下注射,隔日一次,共7次,同时联合静脉注射免疫球蛋白每次5.0g,每周一次共4次,于rhTPO应用的第1天开始应用。结果 18例儿童难治性重型ITP有15例有效,其中6例完全缓解(随访中位时间6个月,有4例呈持续缓解),9例部分缓解(其中4例维持3~4个月后血小板再次下降至≤20×109/L),余3例患儿无效或血小板短暂性升高后快速下降至较低值。结论 rhTPO联合静脉注射免疫球蛋白可使部分难治性重型ITP患儿得到缓解,无明显毒副作用,可成为治疗儿童重型难治性ITP的一种方法。
Objective To evaluate the clinical efficacy of recombinant human thrombopoietin (rhTPO) combined with intravenous immunoglobulin in the treatment of refractory ITP in children. Methods 18 cases of children with intractable heavy ITP were treated with rhTPO combined with intravenous immunoglobulin. RhTPO was administered subcutaneously at 300U / kg once every other day for 7 times. At the same time, intravenous immunoglobulin was administered 5.0g each time, Once a week for 4 times, starting on day 1 of the rhTPO application. Results Eighteen cases of refractory ITP were effective in 15 cases, of which 6 cases were completely relieved (median follow-up was 6 months, 4 cases were sustained remission) and 9 cases were partially relieved (4 cases were maintained for 3 to 4 months After platelet again dropped to ≤ 20 × 109 / L), more than 3 cases of children with transient or transiently decreased platelet rapidly decreased to a lower value. Conclusions rhTPO combined with intravenous immunoglobulin can relieve some patients with refractory severe ITP without obvious toxic and side effects and may become a method to treat severe refractory ITP in children.