Therapeutic Selection of Refractory Immune Thrombocytopenic Purpura

Objective To select a method of treating refractory immune thrombocytopenic purpura through comparing the clinical efficacy of two treatment methods.Methods According to registration order,180 patients with refractory immune thrombocytopenic purpura in accord with diagnostic criteria were randomly divided into treatment group and control group(each n=90).The patients in the two groups were orally given prednisone tablets 1 mg/kg·d,2 times per day,taking 2 weeks and then gradually reducing the maintenance to the disabled.On this basis,treatment group was orally administrated all-trans retinoic acid,10 mg,3 times a day.The duration of treatment of the two groups was 4 weeks.The therapeutic effects were observed after the treatment.Results The curative rates of treatment group and control group were 60.00% and 40.00%,respectively;and the difference was statistically significant(P0.05).The total effective rates of treatment group and control group were 93.33 and 80.00%,respectively;and the difference was statistically significant(P0.01).After the treatment,CD4+CD25+T cells and CD4+CD25highT cells in treatment group were lower than those of control group(P0.01).There was a significant change in CD4+CD25+T cells and CD4+CD25highT cells of treatment group between before and after the treatment(P0.05),while no significant change was found in control group between before and after the treatment(P0.05).After the treatment,there were statistically significant differences in the increase of blood platelet count and the effective bleeding-arrest time between treatment group and control group(P0.01).Conclusions Using all-trans retinoic acid in treatment of refractory immune thrombocytopenic purpura can significantly improve the clinical efficacy,and with the advantages of less side effect and lower price.