CAJ | 학술논문

目的：研究小剂量利妥昔单抗（rituximab）治疗老年慢性难治性免疫性血小板减少症（ITP）的疗效和安全性。方法收集河北省邢台市人民医院血液科36例老年慢性难治性 ITP 患者，静脉注射 rituximab 100 mg ，每周1次，共4周。观察疗效和不良反应，随访12月。比较治疗前后血小板（PLT ）、白细胞（WBC）、白细胞分化抗原8＋（CD8＋）、CD19＋淋巴细胞数和免疫球蛋白（IgG ，IgM ，IgA ）的区别。结果治疗后患者完全反应（CR）17例（47．2％），有效（R）11例（30．6％），无效（NR）8例（22．2％），2例患者发生轻度头晕、胸闷；患者治疗后 PLT 显著上升（P ＝0．001），CD19＋淋巴细胞数明显下降（ P ＝0．001）， WBC 、CD8＋淋巴细胞数和血清免疫球蛋 IgG 、IgM 、IgA 治疗前后无明显变化（P＞0．05）。结论小剂量 rituximab 治疗老年难治性 ITP 具有较好的临床效果、不良反应轻微，可作为老年慢性难治性 ITP 的有效治疗方案之一。
목적：연구소제량리타석단항（rituximab）치료노년만성난치성면역성혈소판감소증（ITP）적료효화안전성。방법수집하북성형태시인민의원혈액과36례노년만성난치성 ITP 환자，정맥주사 rituximab 100 mg ，매주1차，공4주。관찰료효화불량반응，수방12월。비교치료전후혈소판（PLT ）、백세포（WBC）、백세포분화항원8＋（CD8＋）、CD19＋림파세포수화면역구단백（IgG ，IgM ，IgA ）적구별。결과치료후환자완전반응（CR）17례（47．2％），유효（R）11례（30．6％），무효（NR）8례（22．2％），2례환자발생경도두훈、흉민；환자치료후 PLT 현저상승（P ＝0．001），CD19＋림파세포수명현하강（ P ＝0．001）， WBC 、CD8＋림파세포수화혈청면역구단 IgG 、IgM 、IgA 치료전후무명현변화（P＞0．05）。결론소제량 rituximab 치료노년난치성 ITP 구유교호적림상효과、불량반응경미，가작위노년만성난치성 ITP 적유효치료방안지일。
Objective To study the efficacy and safty of low dose rituximab therapy in elderly patients with chronic refractory immune thrombocytopenia(ITP) .Methods 36 elderly patients with chronic refractory ITP were collected from Xingtai People′s Hospital of Hebei ,the patients were given intravenous injection of intravenous rituximab at the dose of 100 mg once weekly for 4 consecutive weeks ,observing the efficacy and adverse reaction and following up for 12 months .Difference of platelet (PLT ) ,white blood cell (WBC) ,cluster differentiation 8 + (CD8 + ) ,CD19 + eukomonocyte number and immunoglobulin (IgG ,IgM ,IgA )were compared before and after treatment .Results The responses of complete remission (CR)were 17 casese(47 .2% ) ,remission (R) were 11 casese (30 .6% ) and no remission (NR) 8 casese (22 .2% ) respectively ,2 patients experienced mild dizziness and chest tightness ;PLT were significantly increased ( P = 0 .001) after treatment ,CD19 + lymphocyte count decreased significantly (P =0 .001) ,WBC ,CD8 + lymphocyte and serum immunoglobulin IgG ,IgM ,IgA showed no significant difference before and after treat-ment(P> 0 .05) .Conclusion Low dose rituximab had better clinical efficacy for the treatment of elderly patients with chronic re -fractory ITP ,low dose rituximab may be a effective treatment in elderly chronic refractory ITP patients with minor adverse reac -tions .