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Objective To compare the efficacy and adverse reaction of rituximab injection( Rituximab) and splenectomy in the treatment of adult chronic idiopathic thrombocytopenic purpura ( ITP). Methods From March 2013 to June 2015,105 chronic ITP patients who were treated in the Fifth People＇s Hospital of Datong were divided into rituximab group(n=43) and splenectomy group( n =62).The clinical efficacy,adverse reaction and survival time of the two groups were compared.Results There was no statistically significant difference in baseline character-istics between the two groups. After treatment for 3 months, the response rates of the splenectomy group and the rituximab group were 91. 9%( 57/62 ), 69. 8%( 30/43 ), respectively, the difference was statistically significant between the two groups(χ2 =5.04,P=0.005).After treatment for 12 months,the response rates of the splenectomy group and the rituximab group were 88.7%(55/62),58.1%(25/43),respectively,the difference was statistically significant between the two groups ( χ2 =6. 83, P =0. 001 ), respectively. After treatment for 3,12 months, the complete response rates of the splenectomy group were 82.2%(51/62),80.6%(50/62),respectively,which were higher than those of the rituximab group [39.5%(17/43),34.9%(15/43)] (χ2 =7.25,P＜0.001).There was no statistically significant difference in adverse reactions after treatment for 1 year between the two groups(P>0.05). The survival time of the splenectomy group was longer,but there was no statistically significant difference( t=4.85, P=0.18).Conclusion The curative effect of splenectomy in the treatment of adult ITP is better than rituximab,and the adverse reaction is not obvious between two methods.
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Objective@#To compare the efficacy and adverse reaction of rituximab injection(Rituximab) and splenectomy in the treatment of adult chronic idiopathic thrombocytopenic purpura(ITP).@*Methods@#From March 2013 to June 2015, 105 chronic ITP patients who were treated in the Fifth People's Hospital of Datong were divided into rituximab group(n=43) and splenectomy group(n=62). The clinical efficacy, adverse reaction and survival time of the two groups were compared.@*Results@#There was no statistically significant difference in baseline characteristics between the two groups.After treatment for 3 months, the response rates of the splenectomy group and the rituximab group were 91.9%(57/62), 69.8%(30/43), respectively, the difference was statistically significant between the two groups(χ2=5.04, P=0.005). After treatment for 12 months, the response rates of the splenectomy group and the rituximab group were 88.7%(55/62), 58.1%(25/43), respectively, the difference was statistically significant between the two groups (χ2=6.83, P=0.001), respectively.After treatment for 3, 12 months, the complete response rates of the splenectomy group were 82.2%(51/62), 80.6%(50/62), respectively, which were higher than those of the rituximab group [39.5%(17/43), 34.9%(15/43)] (χ2=7.25, P<0.001). There was no statistically significant difference in adverse reactions after treatment for 1 year between the two groups(P>0.05). The survival time of the splenectomy group was longer, but there was no statistically significant difference(t=4.85, P=0.18).@*Conclusion@#The curative effect of splenectomy in the treatment of adult ITP is better than rituximab, and the adverse reaction is not obvious between two methods.
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Glucocorticoid is the first choice for the treatment of nephrotic syndrome in children. But due to various reasons, nephrotic syndrome becomes hormone dependent or resistant, and progresses into refractory nephrotic syndrome in some children, which forces the clinician to constantly look for new immunosuppressants in order to alleviate the condition.,Rituximab injection (RTX) as a monoclonal antibody against CD20 has been widely used in the treatment of a variety of immune diseases in recent years. The use of RTX in refractory nephrotic syndrome in children, its main adverse effects and possible mechanisms was reviewed in this article.