98例急性特发性血小板减少性紫癜临床分析

Clinical analysis of 98 cases of acute idiopathic or immune thrombocytopenic purpura

目的：分析儿童急性特发性血小板减少性紫癜不同治疗方案的疗效。方法：收集98例我院2005年1月至2007年1月收治的特发性血小板减少性紫癜儿童患者的病历资料,分析儿童急性特发性血小板减少性紫癜不同治疗方案的疗效。结果：①激素组的有效率为：79.59%（39/49）,显效率为67.34%（33/49）;丙种球蛋白加泼尼松组的有效率97.95%（48/49）,显效率91.83%（45/49）;丙种球蛋白加泼尼松组的近期疗效明显优于激素组（P〈0.05）;②丙种球蛋白加泼尼松组的血小板开始上升时间和恢复正常时间明显短于激素组（P〈0.05）;③全组患儿中位随访46（12~60）个月,共有78例患儿治愈,20例患儿转为慢性ITP,不同治疗方式的预后转归无明显差异（P〉0.05）。结论：对于儿童ITP患者的治疗,早期应用丙种球蛋白可明显促进血小板的早期恢复,应该作为一线治疗儿童ITP的药物。

Objective： To explore the efficiency of different therapy in pediatric patients with acute idiopathic or immune thrombocytopenic purpura（ITP）.Methods： Data of 98 pediatric patients with acute ITP who had admitted to our hospital from January 1,2005 to January 1,2007 were analyzed.Results： The excellence rate and the effective rate in Pred group was 67.34% and 79.59%,respectively;and these in IVIG group was 91.83% and 97.95%,respectively.So the IVIG group was more efficient than the Pred group in the patients′early reaction In IV IG group,time to platelet elevation and time to platelet normalization were all shorter than these in Pred group.After a median follow up of 46 months（range： 12～60 months）,a total of 78 patients were cured and 20 patients converted to chronic ITP,and there was no statistic difference in the patients′ prognosis（P0.05） between the two groups.Conclusion： In pediatric patients with ITP,early diagnosis and treatment were very important,especially the early use of IVIG,which could evaluate the level of platelet rapidly and reduce the convert ratio of chronic ITP.