糖皮质激素与口服环磷酰胺联合治疗过敏性紫癜63例疗效观察

Curative effect observation of glucocorticoid combined with oral cyclophosphamide in the treatment of henoch-schonlein purpura in 63 cases

目的探讨糖皮质激素与口服环磷酰胺联合使用对过敏性紫癜的临床治疗效果。方法回顾分析我院收治的63例发生过敏性紫癜的患儿临床采用糖皮质激素与口服环磷酰胺进行治疗的效果。结果本研究选取的所有患儿在经过糖皮质激素或环磷酰胺治疗5～10d后，皮肤紫癜、腹痛、关节痛等症状均已完全消失，3—12周内蛋白尿、血尿消失，总有效率为100％；停药后1年内有12例患儿复发，所有复发者均没有采用环磷酰胺进行治疗，对于复发的患儿均采用环磷酰胺加泼尼松进行联合治疗，经过4—8周治疗后，所有患儿均已痊愈，随访1年，均没有发生复发，在本研究中，痊愈患儿有51例，占80．95％；有效12例，占19．05％；无效0例。结论采用糖皮质激素与口服环磷酰胺联合治疗过敏性紫癜安全可靠，值得临床推广。

Objective To discuss the clinical therapeutic effect of glucoeortieoid combined with oral cyclophosphamide in the treatment of henoeh-schonlein purpura. Methods The therapeutic effect of 63 children with henoch-schonlein purpura who were treated with glucocorticoid combined with oral cyclophosphamide in our hospital were retrospectively analyzed. Results The skin purpura, abdominal pain and joint pain symptoms of all children at 5-10 days after glucoeorticoid combined with oral cyclophosphamide treatment disappeared completely, proteinuria and hematuria disappeared within 3-12 weeks, and the total effective rate was 100%;12 cases relapsed within a year after discontinue medication, all relapsed cases had not been used cyclophosphamide treatment and were given cyclophosphamide combined with prednisone treatment. After 4-8 weeks of the treatment, all children had been cured, and no relapse occurred within 1 year follow-up. In this study, there were 51 cases（80.95%） of recovery and 12 cases（19.05%） in effective, no a case invalid. Conclusion Glucocorticoid combined with oral cyclophosphamide in the treatment of henoch-sehonlein purpura is safe, reliable and worthy of clinical widely popularization.