免疫抑制剤とくにステロイド治療

抄録

Fifty six (56) chronic ITP cases were treated with steroid hormone over one year and the effectiveness of steroid was evaluated. Fourty one cases (66.1%) showed good response (platelet counts≥10×10⁴/μl) to the initial steroid treatment within 15∼80 days (mean 29.4 days) and the platelet counts increased depend on cumulative dose of steroids (prednisolone, β-methasone). The clinical and hematological responsiveness after at least one year of steroid treatment was observed in 9 cases were complete remission (platelets≥10×10⁴/μl) reaching to the drug free, in 18 cases of partial remission (Plts≥10×10⁴/μl), 10 cases of minor response (5×10⁴≤Plts 10×10⁴/μl) and 19 cases of non responder (plts<5×10⁴/μl). The CR and PR groups showed good response to initial therapy and the pretreatment period from the onset was shorter than that of MR or NR. Since there was no remarkable correlation between the clinical response to steroid and the PAIgG level or other various autoantibodies level, the prediction of steroid responsiveness before treatment was difficult by these serological findings. The complications of steroid therapy were found in steroid unresponsive cases who were treated with large amount of steroid for long period.
These analysis mentioned that the prednisolone (β-methasone) treatment should be the first choice for the initial treatment of ITP to relieve bleeding tendency and to increase the platelet counts rapidly in above half cases (48%).