大剂量地塞米松治疗小儿特发性血小板减少性紫癜

Clinical investigation of treating idiopathic thrombocytopenic purpura(ITP) by high dose dexamethasone

研究目的探讨大剂量地塞米松对小儿特发性血小板减少性紫症的治疗作用；研究背景小儿特发性血小板减少性紫癜激素治疗多为常规量强的松口服，但许多病倒无效。选用激素类型及剂量来提高疗效已成为小儿特发性血小板减少性紫疫治疗中的重要问题。研究方法地塞米松1～2mg／kg,每日1次静滴，连用7～10天减量，2～3周后改强的松。服渐停药。对照组为常规量强的松口服。治疗期间每周查血常犯、血小板2次。结果治疗组34例，有效30例（88.24％），其中慢性型12例；对照组40例，有效22例（55.00％），慢性型4例。经过统计学处理疗效差异非常显著（P＜0.01）.结论大剂量地塞米松治疗小儿特发性血小板减少性紫疾显效快、疗程短、副作用小，且对常规强的松口服无数者仍能获效。

Objective To investigate the treatment effect of high dose of dexamethasone for ITP in children.Background The steroid therapy of children ITP was mostly routine cral administration of prednison, however, considerable cases were inefficacy. How to select steroid type and dose to iinprove healing effeet has been a important af fair in children ITP. Method Dexamethasone 1 - 2 mg/ kg, qd.venoclysis for a period of 7 ~ 10 days and then extenuation. After a Period of 2 - 3 weeks, the drug was turned into prednisone oral for a Period and then withdrawal gradually.Simultaneously, routine prednisone of oral administration was carried out in control group. The blood routine examination and platelet were detected for twice every week in treating Period. Results The effeetive cases were 30 (88.24%)in 34 cases of treating goroup, and 22 (55.00%) in 40 cases of control group resPeCtively. The effective cases in chronic tm were 12 / 14 cases and 4 / 16 cases respetively. By statistical analySis, a swifi cant differenee was observed between treating group and control group (P<0.01).Conclution High dose of dexamethasone possessed becoming effeCtive fast, treating period short, side effeCt minimum and also sultable for patients losing efficancy by rouhne oral prednisone for treatment of ITP in children.