疫性血小板減少性紫癜(1)(編輯修改稿)
2025-06-22 13:32 本頁面
【文章內(nèi)容簡介】 at the time of starting of the investigated treatment。 for postsplenectomy response evaluation, basal platelet count refers to the platelet count before patient was first treated (initial treatment). ? Late responses not attributable to the investigated treatment should not be defined as CR or R (see Table 3). ? The 2 definitions are not mutually exclusive: the first definition, collectively represented using KaplanMeyer analysis, is more suitable for shortcourse treatments aimed at inducing prolonged remission of the disease, whereas the second one is more suitable to evaluate the overall benefit of continuous or intermittent repeated administration of agents 。 治療目標(biāo) 治療反應(yīng)的界定 ? Individual agents for treatment of ITP and the time to the first and peak responses if using the reported dose range ? Agent treatment Reported dose range Time to initial response Time to peak response ? Prednison 14 mg/kg po daily 14 wk 414 d 728 d ? Dexamethasone,40 mg po or iv daily 4 d d214d 428 d ? for 46 courses every 1428 ? IVIg 41 g/kg per dose iv (15 doses) 13 d 27 d ? AntiD 75 μg/kg per dose iv 13 d 37 d ? Rituximab 375 mg/m2 per dose iv 756 d 14180 d ? (4 weekly doses) ? Splenectomy Laparoscopic 156 d 756 d ? Vincristine4 up to 2 mg/dose iv ? (46 weekly doses) 714 d 742 d ? Vinblastine mg/kg per dose iv ? (6 weekly doses) 714 d 742 d ? Danazol 400800 mg po daily 1490 d 28180 d ? Azathioprine 2 mg/kg po daily 3090 d 30180 d ? AMG 310 μg/kg weekly sc 514 d 1460 d ? Eltrombopag 5075 mg po daily 728 d 1490 d 難治性 ITP定義、治療目標(biāo)及 反應(yīng)評估 ? 難治性患者應(yīng)滿足 2個(gè)標(biāo)準(zhǔn)：脾切除失敗或術(shù)后復(fù)發(fā)；患者表現(xiàn)為嚴(yán)重 ITP或出血危險(xiǎn)性需要治療。 ? 難治性患者可能對激素或丙種球蛋白治療暫時(shí)有效；對切脾的反應(yīng)非常重要，對藥物治療無反應(yīng)的非脾切除患者應(yīng)描述為“對一種或多種藥物無反應(yīng)的新診斷的、出血性的或慢性 ITP”,這些患者不一定是嚴(yán)重 ITP。 難治性 ITP定義、治
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