糖皮质激素治疗儿童过敏性紫癜疗效及毒副作用观察

The effect and side effects observation of glucocorticoids in treatment of children with henoch-schonlein purpura

目的系统观察糖皮质激素在儿童过敏性紫癜(HSP)治疗中的有效性及安全性。方法 50例HSP患儿分两组进行观察,30例轻症为琥珀酸氢考(HCSS)治疗组,20例重症为甲基泼尼松龙(MP)治疗组。所有患儿均建立专病随访档案,观察临床症状控制时间,并于糖皮质激素治疗前、治疗过程中及停药后系统观察并记录毒副作用。结果皮疹、关节及消化道症状均于治疗3月内完全控制缓解;14例肾受累患儿中13例(92.9%)尿常规于糖皮质激素治疗4周内恢复正常,1例治疗4周未转阴者加用雷公藤治疗后于病程8周转阴。糖皮质激素治疗后全部患儿BMI值较用药前均增高,停药后恢复,与用药前比较无显著性差异;两组患儿用药期间出现心电图异常者各1例,停药后均恢复正常;肝肾功能、血液、骨骼等系统毒副作用不明显。结论本组观察结果初步显示琥珀酸氢考和甲基泼尼松龙应用于病情轻重不等的儿童HSP治疗是安全有效的。

Objective To observe the efficacy and safety of glucoeorticoid in the treatment of children with Henoch-Sehonlein purpura. Methods 50 eases of HSP were divided into 2 groups： 30 mild eases were divided to hydrocortisone sodium succinate （ HCSS ） treatment group, 20 severe cases were divided to methylprednisolone （ MP ） treatment group. We set up a special disease follow-up record for all the patients, observed the clinical symptom control time of all the patients, and also we observed and recorded the side effects indicators of glucocorticoid before the treatment, during the treatment and after the treatment. Results All children with skin rashes, joint and gastrointestinal symptoms were completely controlled within 3 months of treatment. The urine examination of 13 eases of 14 patients （ 92.9% ） with renal involvement returned to normal with glueoeortieoid treatment in 4 weeks. The urine examination is still with protein of 1 patient in MP group with glucocortieoid treatment for 4 weeks, but it to be normal in the course of 8 weeks when combined withTripterygium. The BMI values Of all children with glucocorticoid treatment were significantly higher than before,treatment, but compared with before treatment the two groups showed no significant difference after stopping drug while the BMI values of all the patients recoved. During the treatment, 1 patient of each group appeared ECG abnormal, their ECG returned to normal after the treatment. There were not obvious side effects on liver and kidney function, blood and bones system. Conclusion The results showed that hydrocortisone sodium succinate and methylprednisolone used in mild or sever cases of children with HSP are safe and effective.