Clinical Observation of Mycophenolate Mofetil Combined with Dexamethasone in the Treatment of Refractory Ididpathic Thrombocytopenic Purpura

OBJECTIVE:To evaluate clinical efficacy and adverse reactions of mycophenolate mofetil combined with dexamethasone in the treatment of refractory thrombocytopenic purpura.METHODS:32 cases of refractory idiopathic thrombocytopenic purpura were randomly divided into the treatment group and the control group(n=16).Both groups received dexamethasone 40 mg·d-1(oral,d1-4,once a month) for 6 months.Patients in the treatment group received mycophenolate mofetil 1.0 g(twice a day,oral,d1-20,once a month) for 6 months.The changes of hepatic function,renal function and platelet count,as well as a series of adverse reactions such as vomiting,diarrhea,leucopenia and infection during the treatment period should be monitored.RESULTS:The obvious effective rate and total effective rate of treatment group were 56.2% and 93.7%.Those of control group were 25.0% and 68.7%.There were significant difference between 2 groups(P0.01).However,the hepatic and renal function of 2 groups were kept at normal levels without obvious ADR.CONCLUSION:Mycophenolate mofetil combined with dexamethasone is better than dexamethasone alone in the treatment of refractory idiopathic thrombocytopenic purpura.No obvious ADR is observed in 2 groups during treatment.