The Efficacy And Safety Observation Of High-dose Dexamethasone Combined With RhTPO In Tretment Of Initial Adult ITP

Objective:To evaluate the efficacy and safety of high dose dexamethasone combined with recombinant thrombopoietin(rhTPO) in treatment of adut initial ITP.Methods:We retrospectively analysed 80 cases of ITP patients,divided them into two groups, experimental group and control groupin,the experimental group patients were given high-dose dexamethasone combined with rhTPO treatment,control group patients were given single high-dose dexamethasone treatment.In experimental group dexamethasone were used with rhTPO began on the same day, patientes were gave dexamethasone 40 mg/d x 4 day, if effective the enter the withdrawal of follow-up, if invalid the repeated drug use in 11 days to 14 days, rhTPO were 300u/kg/d x 4d subcutaneous injection once a day, if less than 14 days the platelet count> 100 x 109/L or platelet count increased absolute value 50 x 109/L then stopped using rhTPO; The control group given the same solution of dexamethasone treatment.Patients used none of other drugs for the treatment of ITP in the process, if active bleeding appearred, we can give fight fibrinolytic hemostatic and infusion machine mining support treatment, and we must record the bleeding and its outcome.In addition to strictly observe the related indicators of drug treatment in the process, at the same time, we recorded the patient’s drug tolerance and whether therer were any adverse drug reactions.By means of analyzing the karyotype of 56 patients with chronic lymphocytic leukemia, and applying combined probe to do Fluorescence in situ hybridization detection, to understand the relationship between the chromosomal abnormalities,clinical stage and disease progression,disease prognosis.Result:The general information of patients in early treatment of two groups gender, age, baseline platelet levels,there was no statistically significant difference comparison(table 1).The comparison of elevant indicators of the two groups after treatment show:in 4,7,14,30days after treatment the platelet count of the experimental group paticents were higher than the control group, P<0.05 in all of them, the difference was statistically significant; In4,7,14,30days the platelet growth significantly difference,P<0.05, the difference was statistically significant.Except in 4 day, in7,14,30days the number of patients completed remission (CR)were compared in the two grops,in experimental group,it were respectively,6 cases (26.1%) and 17 cases(73.6%), 16 cases (69.6%) and in control group it was respectively 1 cases (4%),9 cases (36%),4 cases (16%), the resut was P<0.05, the difference was statistically significant (table 4).The number of paticents who had blood transfusion in experimental group and control group were 6 people and 11 people respectively, the difference was meaningless (P= 0.237).Conclusion:Combination of high-dose dexamethasone and rhTPO scheme in treatment of ITP patients can enhance the platelet count in a short period of time, then reduced the risk of bleeding,platelet significantly increase and in the long term for complete response rate is high, the effect was distinct, and the adverse reaction of drugs was slightly,they had good security.