CAJ | 학술논문

目的：探讨不同剂量利妥昔单抗治疗慢性免疫性血小板减少症(ITP)的临床疗效、安全性。方法：选取笔者所在科室2011年7月-2013年7月慢性免疫性血小板减少症患者44例，采取随机双盲对照研究法分为标准剂量组和小剂量组。标准剂量组给予利妥昔单抗375 mg/m2，静脉滴注，每周1次，连用4周。小剂量组给予利妥昔单抗100 mg/m2，静脉滴注，每周1次，连用4周。观察两组治疗前后血小板计数区别，观察疗效及不良反应。结果：治疗后，两组患者血小板计数均显著上升，与本组治疗前比较差异均有统计学意义(P<0.05)。两组患者治疗1个月后和治疗3个月后平均血小板计数比较差异均无统计学意义(P>0.05)；两组患者治疗3个月后完全缓解(CR)率及有效(R)率比较差异均无统计学意义(P>0.05)。两组患者均无严重的不良反应。结论：小剂量与标准剂量利妥昔单抗治疗慢性免疫性血小板减少症均有较好疗效，小剂量利妥昔单抗安全有效，值得推广。
목적：탐토불동제량리타석단항치료만성면역성혈소판감소증(ITP)적림상료효、안전성。방법：선취필자소재과실2011년7월-2013년7월만성면역성혈소판감소증환자44례，채취수궤쌍맹대조연구법분위표준제량조화소제량조。표준제량조급여리타석단항375 mg/m2，정맥적주，매주1차，련용4주。소제량조급여리타석단항100 mg/m2，정맥적주，매주1차，련용4주。관찰량조치료전후혈소판계수구별，관찰료효급불량반응。결과：치료후，량조환자혈소판계수균현저상승，여본조치료전비교차이균유통계학의의(P<0.05)。량조환자치료1개월후화치료3개월후평균혈소판계수비교차이균무통계학의의(P>0.05)；량조환자치료3개월후완전완해(CR)솔급유효(R)솔비교차이균무통계학의의(P>0.05)。량조환자균무엄중적불량반응。결론：소제량여표준제량리타석단항치료만성면역성혈소판감소증균유교호료효，소제량리타석단항안전유효，치득추엄。
Objective:To observe the clinical efficacy and safety of different doses of Rituximab in treatment of chronic ITP. Method:The clinical data of 44 patients with chronic ITP from July 2011 to July 2013 were analyzed. In those cases,22 patients of standard dose were treated with Rituximab(375 mg/m2 per week for four weeks),22 patients of lower dose group were treated with Rituximab(100 mg/m2 per week for four weeks),platele count were detected before and after Rituximab therapy,the clinical efficacy and side effect were compared. Result:The two groups of patients with platelet count were significantly increased after treatment compared with before treatment,and the differences were statistically significant(P<0.05). The difference of the platelet counts on average between the two groups after 1 months and 3 months treatment were no statistically significant(P>0.05). The difference of the complete remission rate and effective rate between the two groups after 3 months treatment were no statistically significant(P>0.05). And there were no severe adverse effects during Rituximab therapy in two groups. Conclusion:The two doses of Rituximab in the treatment of chronic ITP have good efficacy. The lower dose rituximab may be an effective and safe modality for patients with chronic ITP,is worthy of promotion.