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目的:探讨以霉酚酸酯(MMF)为主的方案治疗激素无效的成人免疫性血小板减少症(ITP)的疗效和安全性。方法:回顾性分析23例服用MMF(1.0~2.0g/d)治疗的激素无效成人ITP患者,观察疗效及毒副作用。结果:MMF治疗的总体有效率为73.9%(17/23),其中6例(35.3%)完全缓解,11例(64.7%)部分缓解。MMF治疗中位起效时间为27(20~35)d,血小板计数升至峰值的中位时间为69(49~95)d。MMF治疗后,14例(82.4%)患者持续有效,随访时间为15.0(8.5~30.5)个月。MMF治疗有效患者的ITP病程明显短于MMF治疗无效患者的病程(P<0.05);MMF联合激素、环孢素或达那唑治疗的起效时间,明显短于MMF单药治疗的起效时间(P<0.05)。23例患者服用MMF期间未发生严重并发症。结论:MMF对于激素无效的成人ITP有较好的疗效,且毒副作用小。
Objective: To investigate the efficacy and safety of mycophenolate mofetil (MMF) -based regimen in the treatment of hormone-refractory adult immune thrombocytopenia (ITP). Methods: A retrospective analysis of 23 patients with hormone - refractory adult ITP treated with MMF (1.0-2.0 g / d) was performed. The curative effect and side effects were observed. Results: The overall effective rate of MMF was 73.9% (17/23), of which 6 (35.3%) were completely relieved and 11 (64.7%) were partially relieved. Median time to onset of MMF was 27 (20-35) days and platelet count peaked at 69 (49-95) days. After MMF treatment, 14 patients (82.4%) continued to be effective and the follow-up time was 15.0 (8.5-30.5) months. The duration of ITP in MMF-treated patients was significantly shorter than that in MMF-treated patients (P <0.05). The onset of MMF plus corticosteroid, cyclosporine or danazol treatment was significantly shorter than the onset of MMF monotherapy (P <0.05). Twenty-three patients had no serious complications during MMF. CONCLUSION: MMF has a good curative effect on ITP with inactive hormone and little side effect.