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目的探讨大剂量地塞米松冲击治疗初诊成人ITP的临床效果及安全性。方法选取商丘巿第一人民医院2013年6月—2014年6月期间收治的62例ITP患者作为研究对象,按照随机分组法将其分为对照组和观察组,对照组患者给予1mg/kg泼尼松龙口服,持续口服治疗4周,观察组患者给予20mg/d地塞米松静脉滴注治疗,连续滴注治疗5d,并比较2组患者的临床效果及不良反应发生情况。结果与治疗4周时相比,治疗3个月后患者的治疗反应率明显降低,且观察组患者治疗反应率均显著高于对照组(P<0.05);观察组治疗5d、4周和3个月时患者的血小板水平均显著高于对照组(P<0.05);观察组患者治疗期间不良不反应发生率显著少于对照组(P<0.05)。结论大剂量地塞米松冲击疗法在治疗特发性血小板减少性紫癜方面具有起效快、疗效好、不良反应少等优点,该方法值得在临床推广应用。
Objective To investigate the clinical efficacy and safety of high-dose dexamethasone in the treatment of newly diagnosed adult ITP. Methods Sixty-two patients with ITP who were treated in Shangqiu First People’s Hospital from June 2013 to June 2014 were selected as study subjects and divided into control group and observation group according to randomization method. Patients in control group were treated with 1 mg / kg The patients in the observation group were given intravenous drip of 20mg / d dexamethasone for 5 days. The clinical effects and adverse reactions of the two groups were compared. Results Compared with the 4-week treatment, the treatment response rate of the patients in the observation group was significantly lower than that of the control group (P <0.05), and the response rate of the observation group was significantly lower than that of the control group The level of platelet in patients at month 1 was significantly higher than that in control group (P <0.05). The incidence of adverse reactions in observation group was significantly less than that in control group (P <0.05). Conclusion High-dose dexamethasone shock therapy has the advantages of rapid onset, good curative effect and few adverse reactions in the treatment of idiopathic thrombocytopenic purpura. This method is worthy of clinical application.