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作者报告用大剂量经血浆素分解的γ球蛋白静脉滴注治疗15例成人慢性自身免疫性血小板减少性紫癜(AITP)。本组男性6例,女性9例,年龄20-91岁(平均56岁),血小板数均低于3.8万/mm~3(0.5-3.8万/mm~3)至少持续4月,骨髓巨核细胞数增高或正常,血小板相关IgG(PAIgG)除1例外均高于正常,血清IgG量正常,检查7例血小板寿命均缩短。所用的血浆素分解的人的γ球蛋白,含50%完整的IgG(主要是IgG_2和IgG_4)及50%分解为Fab和Fc片段。每疗程的剂量为0.4g/kg/天,配成5%等渗盐水溶液,静脉滴注。开始时滴速应极慢,待耐受后渐增至20ml/小时,6-10小时滴完,连用5天。结果15例中5例完全缓解(血小板恢复至10万/mm~3以上),6例部分缓解(血小板5-10万/mm~3),
The authors report the treatment of 15 adult patients with chronic autoimmune thrombocytopenic purpura (AITP) by intravenous administration of a high dose of plasma-degraded gamma globulin. The group of 6 males and 9 females, aged 20-91 years (mean 56 years), platelet count were less than 3.8 million / mm ~ 3 (0.5-3.8 million / mm ~ 3) for at least 4 months, bone marrow megakaryocytes The number of platelet-associated IgG (PAIgG) was higher than normal in one case, and the serum IgG level was normal. The platelet life span of seven cases was shortened. The plasma-degraded human gamma globulin used contains 50% intact IgG (mainly IgG 2 and IgG 4) and 50% breaks down into Fab and Fc fragments. Each course of the dose of 0.4g / kg / day, dubbed 5% isotonic saline solution, intravenous infusion. The beginning of the drip rate should be very slow, to be tolerated gradually increased to 20ml / hour, 6-10 hours drip finished, once every 5 days. Results Of the 15 cases, 5 cases were completely relieved (platelet recovery was over 100,000 / mm ~ 3), 6 cases were partly relieved (5-10 million / mm ~ 3 platelets)