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Abstract：
Background and Objectives: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by the autoantibody-mediated destruction of platelets. The treatment of ITP aims to maintain a sufficient platelet count to prevent bleeding. First-line treatment options include corticosteroids and intravenous immunoglobulin (IVIg), while second-line treatments include splenectomy, rituximab and other immunosuppressive agents, and thrombopoietin (TPO) receptor agonists. This study aims to discuss the treatment methods and results from 100 patients with ITP at the Muğla Training and Research Hospital through a pharmacological approach. Materials and Methods: Demographic characteristics, clinical findings, bone marrow aspiration and biopsy results, and treatments and treatment responses at the time of diagnosis of the 100 patients with ITP who were treated and followed up in the period 2015-2023 were evaluated retrospectively. Results: In the third month after treatment, the overall response percentage was 100% in patients who received steroids only and 88% in patients who received IVIg treatment alone or in combination with steroids (p > 0.05). The most preferred second-line treatments were splenectomy (41%), eltrombopag (26%), and rituximab (10%). Bone marrow biopsy was performed in 54% of patients, where 35.1% showed increased megakaryocytes, 44.4% adequate megakaryocytes, and 14.8% decreased megakaryocytes. It is noted that eltrombopag and rituximab, in particular, yield higher complete remission rates than immunosuppressive drugs. Conclusions: Considering the side effects of immunosuppressive medications, IVIg, splenectomy, and steroid therapy, the use of new agents such as eltrombopag, which are easily tolerated and have a lower risk of side effects, is expected to increase.
摘要：
背景与目的:免疫性血小板减少症(ITP)是一种以自身抗体介导的血小板破坏为特征的自身免疫性疾病。ITP的治疗旨在维持足够的血小板计数以防止出血。一线治疗选择包括皮质类固醇和静脉注射免疫球蛋白（IVIg），虽然二线治疗包括脾切除术，利妥昔单抗和其他免疫抑制剂，和血小板生成素（TPO）受体激动剂。本研究旨在通过药理学方法讨论Muöla培训和研究医院100名ITP患者的治疗方法和结果。材料和方法：人口统计特征，临床发现，骨髓穿刺活检结果,对2015-2023年接受治疗和随访的100例ITP患者诊断时的治疗和治疗反应进行回顾性评估.结果:治疗后第3个月,仅接受类固醇治疗的患者的总缓解百分比为100%,接受单独或联合使用IVIg治疗的患者的总缓解百分比为88%(p>0.05).最优选的二线治疗是脾切除术(41%)，eltrombopag（26%），利妥昔单抗（10%）。54%的患者进行了骨髓活检，其中35.1%显示巨核细胞增加，44.4%足够的巨核细胞，巨核细胞减少14.8%。值得注意的是，艾曲波巴和利妥昔单抗，特别是,产生比免疫抑制药物更高的完全缓解率。结论：考虑到免疫抑制药物的副作用，IVIg,脾切除术,和类固醇治疗,使用新的药物，如eltrombopag，容易耐受，副作用风险较低，预计会增加。
