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儿童慢性特发性血小板减少性紫癜是由约 2 0 %~ 2 5 %的急性ITP发展而来 ,其治疗特点呈慢性难治性 ,目前治疗包括肾上腺皮质激素、静脉免疫球蛋白、抗D抗体、α -干扰素治疗、脾脏切除及其它免疫抑制治疗。肾上腺皮质激素间歇短程大剂量冲击疗法副作用小、花费低且能获得几乎 5 0 %的有效率 ;静脉免疫球蛋白已广泛用于临床特别对急危重症其疗效可达83~ 88% ;抗D抗体有效率可达 80 % ,且能持续保持良好反应 ;α -干扰素的治疗可用于延迟小儿脾切除或者脾切除术前提高血小板数 ;抗CD2 0 单抗可尝试用于治疗儿童慢性、难治性ITP。脾切除是治疗慢性ITP的有效方法 ,其完全缓解率可达 70~ 80 % ,但应严格掌握指征
Children with idiopathic thrombocytopenic purpura is about 20% ~ 25% of acute ITP development, its treatment characteristics of chronic refractory, the current treatment, including adrenal cortex hormones, intravenous immunoglobulin, anti-D antibody , Alpha interferon therapy, splenectomy and other immunosuppressive therapy. Corticosteroid intermittent short-range high-dose impact therapy with small side effects, low cost and access to almost 50% of the efficiency; intravenous immunoglobulin has been widely used in clinical special critical illness its effect up to 83 to 88%; anti-D Antibody efficiency up to 80%, and can continue to maintain good response; α - interferon treatment can be used to delay pediatric splenectomy or spleen resection before the increase in platelet number; anti-CD20 monoclonal antibody can try to treat children with chronic, difficult Governance ITP. Splenectomy is an effective treatment of chronic ITP, the complete remission rate of up to 70 to 80%, but should be strictly controlled indications