Nomura T, Maekawa T, Uchino H, Miyazaki T, Miura Y, Abe T, Asano S, Kuriya S, Nagai K, Yawata Y
Third Department of Internal Medicine, Nippon Medical School, Tokyo.
Nihon Ketsueki Gakkai Zasshi. 1990 Feb;53(1):98-104.
Thirty-eight patients with chronic refractory idiopathic thrombocytopenic purpura (ITP) were treated with weekly slow infusions of vincristine (0.02 to 0.04 mg/kg) or vinblastine (0.1 to 0.2 mg/kg). Twenty-two patients showed good to excellent responses after one to eight infusions. These responses were generally short, and lasted only in six patients after discontinuance of the therapy. The efficacy was comparable between vincristine and vinblastine. Neither the age, sex, duration of the disease, prior splenectomy nor combined use of adrenocortical steroids was likely to have influenced the therapeutic effect. Side effects such as peripheral neuropathy, alopecia, gastrointestinal symptoms and leukopenia occurred in 34 patients, and necessitated discontinuance of the therapy in eight patients. Slow infusions of vinca alkaloids can be an effective means of inducing platelet response in patients with chronic refractory ITP, but frequent side effects limit its clinical usefulness.
38例慢性难治性特发性血小板减少性紫癜（ITP）患者接受了每周一次的长春新碱（0.02至0.04mg/kg）或长春碱（0.1至0.2mg/kg）缓慢静脉输注治疗。22例患者在接受1至8次输注后显示出良好至极佳的反应。这些反应通常持续时间较短，在治疗停止后仅6例患者仍有反应。长春新碱和长春碱的疗效相当。年龄、性别、病程、既往脾切除术以及肾上腺皮质类固醇的联合使用均不太可能影响治疗效果。34例患者出现了外周神经病变、脱发、胃肠道症状和白细胞减少等副作用，其中8例患者因此需要停止治疗。缓慢静脉输注长春花生物碱可以是诱导慢性难治性ITP患者血小板反应的有效方法，但频繁的副作用限制了其临床应用。
