[1]张彦平,刘蒙蒙,展新荣,等.艾曲波帕治疗激素治疗无效或激素依赖性儿童免疫性血小板减少症疗效观察[J].新乡医学院学报,2021,38(3):264-267.[doi:10.7683/xxyxyxb.2021.03.012]
 ZHANG Yanping,LIU Mengmeng,ZHAN Xinrong,et al.Effect of eltrombopag in the treatment of hormone therapy ineffective or hormone dependent immune thrombocytopenia in children[J].Journal of Xinxiang Medical University,2021,38(3):264-267.[doi:10.7683/xxyxyxb.2021.03.012]
点击复制

艾曲波帕治疗激素治疗无效或激素依赖性儿童免疫性血小板减少症疗效观察
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年3
页码:
264-267
栏目:
临床研究
出版日期:
2021-03-05

文章信息/Info

Title:
Effect of eltrombopag in the treatment of hormone therapy ineffective or hormone dependent immune thrombocytopenia in children
作者:
张彦平刘蒙蒙展新荣李文红
(新乡市中心医院血液内科,河南 新乡 453000)
Author(s):
ZHANG YanpingLIU MengmengZHAN XinrongLI Wenhong
(Department of Hematology,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China)
关键词:
免疫性血小板减少症艾曲波帕 静脉注射用人丙种球蛋白血小板
Keywords:
immune thrombocytopeniaeltrombopaghuman gamma globulin for intravenous injectionplatelet
分类号:
R558.2
DOI:
10.7683/xxyxyxb.2021.03.012
文献标志码:
A
摘要:
目的 探讨艾曲波帕治疗激素治疗无效或激素依赖性儿童免疫性血小板减少症(ITP)的临床效果。方法 选择2018年2月至2019年6月新乡市中心医院收治的30例激素治疗无效或激素依赖性ITP患儿为研究对象,根据治疗方法将患儿分为观察组和对照组,每组15例。对照组患儿给予静脉注射用人丙种球蛋白治疗,观察组患儿给予艾曲波帕治疗,2组患儿均连续治疗6个月。观察2组患儿治疗1、2、3、4、5、6个月时血小板计数(BPC),分别于治疗1、2、4、6个月评估2组患儿临床疗效,并观察治疗期间2组患儿不良反应发生情况。结果 2组患儿治疗前BPC比较差异无统计学意义(P>0.05);2组患儿治疗1、2、3、4、5、6个月BPC均显著高于治疗前(P<0.05),且随着治疗时间延长,BPC呈逐渐升高趋势;治疗1、2、3、4、5、6个月,观察组患儿BPC均显著高于对照组(P<0.05)。治疗1、2、4、6个月,观察组患儿治疗总有效率分别为53.33%(8/15)、66.67%(10/15)、80.00%(12/15)、86.67%(13/15),对照组患儿治疗总有效率分别为33.33%(5/15)、46.67%(7/15)、60.00%(9/15)、73.33%(11/15),观察组患儿治疗总有效率显著高于对照组(P<0.05),且随着治疗时间延长,2组患儿总有效率呈逐渐升高趋势。观察组患儿胃肠道反应、肝功能异常及肾功能异常的发生率分别为20.00%(3/15)、20.00%(3/15)、13.33%(2/15),对照组患儿胃肠道反应、肝功能异常及肾功能异常的发生率分别为13.33%(2/15)、6.00%(1/15)、6.00%(1/15);观察组患儿胃肠道反应、肝功能异常、肾功能异常的发生率显著高于对照组(P<0.05)。2组患儿的胃肠道反应、肝功能异常、肾功能异常均比较轻微,经对症处理后恢复正常,不影响治疗。结论 艾曲波帕治疗激素治疗无效或激素依赖性儿童ITP疗效确切,患者耐受良好。
Abstract:
Objective To investigate the clinical effect of eltrombopag in the treatment of hormone therapy ineffective or hormone dependent immune thrombocytopenia (ITP) in children.Methods  Thirty children with hormone therapy ineffective or hormone dependent ITP admitted to Xinxiang Central Hospital from February 2018 to June 2019 were selected as the research subjects,and the children were divided into observation group and control group according to the treatment methods,with fifteen cases in each group.The children in the control group were treated with human gamma globulin for intravenous injection,while the children in the observation group were treated with eltrombopag,all children were treated for six months.The blood platelet count (BPC) of the children in the two groups was observed at 1,2,3,4,5 and 6 months of treatment.The clinical effect of the children in the two groups was evaluated at 1,2,4 and 6 months of treatment,and the adverse reactions of the children in the two groups were observed.Results There was no significant difference in BPC between the two groups before treatment (P>0.05).The BPC of the children in the two groups at 1,2,3,4,5 and 6 months of treatment was significantly higher than that before treatment (P<0.05).With the prolongation of treatment time,the BPC gradually increased.At 1,2,3,4,5 and 6 months of treatment,the BPC of children in the observation group was significantly higher than that in the control group (P<0.05).At 1,2,4 and 6 months of treatment,the total effective rate in the observation group was 53.33% (8/15),66.67% (10/15),80.00% (12/15) and 86.67% (13/15),respectively;while the total effective rate in the control group was 33.33% (5/15),46.67% (7/15),60.00% (9/15) and 73.33% (11/15),respectively;the total effective rate in the observation group was significantly higher than that in the control group (P<0.05),and with the prolongation of treatment time,the total effective rate increased gradually.The incidence of gastrointestinal reaction,liver function abnormality and renal function abnormality in the observation group was 20.00% (3/15),20.00% (3/15) and 13.33% (2/15),respectively.The incidence of gastrointestinal reaction,liver function abnormality and renal function abnormality in the control group was 13.33% (2/15),6.00% (1/15) and 6.00% (1/15),respectively.The incidence of gastrointestinal reaction,liver function abnormality and renal function abnormality in the observation group was significantly higher than that in the control group (P<0.05).The gastrointestinal reaction,liver function abnormality and renal function abnormality of the children in the two groups were mild,and the adverse reactions returned to normal after symptomatic treatment and did not affect the treatment.Conclusion Eltrombopag is effective and well tolerated in the treatment of children with hormone therapy ineffective or hormone dependent ITP.

参考文献/References:

[1] 中华医学会儿科学分会血液学组.儿童原发性免疫性血小板减少症诊疗建议[J].中华儿科杂志,2013,51(5):382-384.
[2] 吴润晖,马洁.儿童免疫性血小板减少症的治疗策略[J].中华实用儿科临床杂志,2017,32(15):1124-1128.
[3] 童汝雁,金皎,黄璟,等.儿童免疫性血小板减少症预后相关因素[J].中华实用儿科临床杂志,2019,34(11): 837-841.
[4] 马洁,傅玲玲,张利强,等.短疗程大剂量地塞米松作为儿童免疫性血小板减少症一线治疗的疗效及安全性评估[J].中华实用儿科临床杂志,2019,34(21): 1640-1644.
[5] 徐卫群.儿童原发性免疫性血小板减少症新药研发进展[J].中华实用儿科临床杂志,2017,32(15):1129-1132.
[6] 谢晓恬.儿童免疫性血小板减少症发病机制与诊治研究进展[J].中国小儿血液与肿瘤杂志,2017,22(1):51-54.
[7] 范蕊,石太新.儿童免疫性血小板减少症发病机制研究进展[J].新乡医学院学报,2015,32(5):466-469.
[8] 李培岭,王欣欣,范蕊,等.T淋巴细胞相关细胞因子与儿童慢性免疫性血小板减少症转归的相关性研究[J].中华实用儿科临床杂志,2020,35(3):206-209.
[9] 中华医学会血液学分会止血与血栓学组.成人原发免疫性血小板减少症诊断与治疗中国专家共识(2016年版)[J].中华血液学杂志,2016,37(2):89-93.
[10] 王欣欣,刘豹,郭路阳,等.T淋巴细胞相关细胞因子在儿童免疫性血小板减少症转归中的意义[J].新乡医学院学报,2019,36(9):864-865.
[11] MCMILLAN R.The pathogenesis of chronic immune thrombocytopenic purpura[J].Semin Hematol,2007,44(4/5):S3-S11.
[12] NEUNERT C,LIM W,CROWTHER M,et al.The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia[J].Blood,2011,117(16):4190-4207.
[13] 黄月婷,刘晓帆,付荣凤,等.艾曲波帕治疗成人原发免疫性血小板减少症的临床分析[J].临床血液学杂志,2019,32(1):16-19.
[14] GRAINGER J D,LOCATELLI F,CHOTSAMPANCHAROEN T,et al.Eltrombopag for children with chronic immune thrombocytopenia (PETIT2): a randomised,multicentre,placebo-controlled trial[J].Lancet,2015,386(10004):1649-1658.
[15] 黄月婷,刘晓帆,陈云飞,等.艾曲泊帕治疗儿童原发免疫性血小板减少症23例临床观察[J].中华血液学杂志,2019,40(12):1031-1034.

相似文献/References:

[1]闫彦睿,王志银,李培岭,等.调节性T细胞和淋巴细胞亚群在儿童免疫性血小板减少症发病中的意义[J].新乡医学院学报,2021,38(2):129.[doi:10.7683/xxyxyxb.2021.02.006]
 YAN Yanrui,WANG Zhiyin,Li Peiling,et al.Significance of regulatory T cell and lymphocyte subsets in the pathogenesis of immune thrombocytopenia in children[J].Journal of Xinxiang Medical University,2021,38(3):129.[doi:10.7683/xxyxyxb.2021.02.006]
[2]郭路阳,范 蕊,肖爱菊,等.免疫性血小板减少症患儿外周血中DNA甲基转移酶蛋白表达及临床意义[J].新乡医学院学报,2018,35(8):681.[doi:10.7683/xxyxyxb.2018.08.008]
 GUO Lu-yang,FAN Rui,XIAO Ai-ju,et al.Expression and clinical significance of DNA methyltransferase protein in children with immune thrombocytopenia[J].Journal of Xinxiang Medical University,2018,35(3):681.[doi:10.7683/xxyxyxb.2018.08.008]
[3]刘 豹,石太新,赵东菊,等.免疫性血小板减少症患儿外周血T淋巴细胞相关细胞因子水平变化[J].新乡医学院学报,2018,35(12):1089.[doi:10.7683/xxyxyxb.2018.12.011]
 LIU Bao,SHI Tai-xin,ZHAO Dong-ju,et al.Levels and clinical significance of T lymphocyte related cytokines in peripheral blood in children with immune thrombocytopenia[J].Journal of Xinxiang Medical University,2018,35(3):1089.[doi:10.7683/xxyxyxb.2018.12.011]
[4]罗雅琴,黄 伟.细胞自噬在免疫性血小板减少症中的作用机制研究进展[J].新乡医学院学报,2022,39(4):381.[doi:10.7683/xxyxyxb.2022.04.017]
 LUO Yaqin,HUANG Wei.Research progress on the mechanism of autophagy in immune thrombocytopenia[J].Journal of Xinxiang Medical University,2022,39(3):381.[doi:10.7683/xxyxyxb.2022.04.017]

更新日期/Last Update: 2021-03-05