Jubelirer S J
Cancer Care Center, Southern West Virginia Charleston Area Medical Center.
Am J Hematol. 1993 May;43(1):44-6. doi: 10.1002/ajh.2830430110.
The treatment of corticosteroid- and/or splenectomy-refractory immune thrombocytopenic purpura (ITP) includes vinca alkaloids, immunosuppressives, Danazol, intravenous gammaglobulin, and alpha-interferon. However, these treatments have often been associated with toxic side effects. Brox et al. (Br J Haematol 70:341-344, 1988) reported the efficacy of ascorbic acid in the treatment of ITP; the platelet count normalized in seven of 11 patients studied, and tolerance was excellent. However, other investigators have reported less impressive results. These conflicting reports prompted a pilot study of ascorbic acid in 12 patients with refractory ITP. Patients were given 2 g every morning for at least 10 weeks. All have received glucocorticoids, three had undergone splenectomy, and six received other treatments. The maximal increase in platelet count above baseline (i.e., the prestudy platelet count) achieved was < 20,000 in 11 patients and 25,000 in one patient. Therapy was well tolerated, with only two patients complaining of dyspepsia. The results of this study suggest that ascorbic acid is not very effective in patients with refractory ITP.
皮质类固醇和/或脾切除难治性免疫性血小板减少性紫癜（ITP）的治疗方法包括使用长春花生物碱、免疫抑制剂、达那唑、静脉注射丙种球蛋白和α干扰素。然而，这些治疗方法常常伴有毒性副作用。布罗克斯等人（《英国血液学杂志》70:341 - 344, 1988年）报道了抗坏血酸治疗ITP的疗效；在11例研究患者中，有7例血小板计数恢复正常，且耐受性良好。然而，其他研究者报告的结果却没那么令人印象深刻。这些相互矛盾的报告促使对12例难治性ITP患者进行了抗坏血酸的初步研究。患者每天早晨服用2克，至少服用10周。所有患者均接受过糖皮质激素治疗，3例接受过脾切除术，6例接受过其他治疗。11例患者血小板计数较基线（即研究前血小板计数）的最大增幅<20,000，1例患者为25,000。治疗耐受性良好，只有2例患者抱怨有消化不良症状。该研究结果表明，抗坏血酸对难治性ITP患者不太有效。
