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目的探讨环孢素A(CyA)在难治/复发性免疫性血小板减少症(ITP)治疗中的临床疗效和不良反应。方法 36例难治/复发ITP患者接受3~5mg/(kg.d)的CyA治疗并观察疗效和不良反应。结果中位随访10个月,完全反应(CR)13例(36.1%),有效(R)15例(41.7%),无效(NR)8例(22.2%),总有效率为77.8%。复发与难治两组疗效差异比较无统计学意义(P=0.083)。常见的不良反应为胃肠道反应、头痛、血压升高及肝功能受损,多数患者能较好耐受。结论低剂量的CyA治疗ITP是一种高效、安全的挽救性治疗方法,严重不良反应较少。
Objective To investigate the clinical efficacy and adverse reactions of cyclosporin A (CyA) in refractory / relapsed immune thrombocytopenia (ITP). Methods Thirty - six patients with refractory / recurrent ITP received 3 ~ 5 mg / (kg · d) CyA and the curative effect and adverse reaction were observed. Results The median follow-up was 10 months. Complete response (CR) was observed in 13 cases (36.1%), effective (R) in 15 cases (41.7%) and ineffectiveness (NR) in 8 cases (22.2%) with a total effective rate of 77.8%. There was no significant difference between the two groups in recurrence and refractory (P = 0.083). Common adverse reactions are gastrointestinal reactions, headaches, elevated blood pressure and impaired liver function, and most patients are well tolerated. Conclusions Low-dose CyA treatment of ITP is an effective and safe salvage therapy with fewer serious adverse reactions.