不同剂量丙种球蛋白联合激素治疗小儿特发性血小板减少性紫癜疗效对比分析

Contrast Analysis of Curative Effect of Different Doses of Gamma Globulin Combined Hormone Therapy in Children with Idiopathic Thrombocytopenic Purpura

目的:对比两种不同剂量丙种球蛋白联合激素对小儿特发性血小板减少性紫癜(ITP)的治疗效果。方法:选取本院2010-2012年收治的84例小儿特发性血小板减少性紫癜患者,将其随机分为大剂量组、小剂量组和对照组,三组均接受地塞米松及常规基础治疗,在此基础上大剂量组加用丙种球蛋白400 mg/(kg·d),小剂量组加用丙种球蛋白200 mg/(kg·d),比较三组患者治疗效果。结果:大剂量组血小板开始上升时间为(3.17±1.42)d,小剂量组为(3.09±1.87)d,差异无统计学意义(P>0.05),但两组均显著短于对照组的(5.46±2.13)d(P<0.05)。大剂量组血小板升至正常时间为(7.42±2.78)d,小剂量组为(7.67±2.94)d,差异无统计学意义(P>0.05),但均短于对照组的(9.83±3.21)d(P<0.05)。大剂量组总有效率为96.4%,小剂量组为92.9%,差异无统计学意义(P>0.05),但均显著高于对照组的82.1%(P<0.05)。结论:丙种球蛋白联合糖皮质激素对儿童ITP疗效确实,能迅速升高血小板及控制出血倾向,小剂量丙种球蛋白治疗效果与大剂量相当,但治疗成本更低。

Objective：To compare the therapy effectiveness of two different dosages of immunoglobin combined with glucocorticoid on idiopathic thrombocytopenic purpura（ITP）.Method：84 patients of ITP were randomly divided into groups of large and small dosage and control group.All groups accepted basal treatment while large dosage group had immunoglobin 400 mg/（kg·d）and small dosage group had immunoglobin 200 mg/（kg·d） in addition.The effectiveness of 3 groups was observed.Result：The large dosage group had similar platelet rise start time of（3.17±1.42）d with small dosage group of（3.09±1.87）d（P〈0.05）,and time of both group were shorter than control group of（5.46±2.13）d（P〈0.05）.Large dosage group had similar platelet rise to normal time of（7.42±2.78）d with small dosage group of（7.67±2.94）d（P〈0.05）,and time of both group were shorter than control group of（9.83±3.21）d（P〈0.05）.Large dosage group had similar effective rate of 96.4% with small dosage group of 92.9%（P〈0.05）while both higher than control group of 82.1%（P〈0.05）.Conclusion：Immunoglobin combined with glucocorticoid is effective to ITP and helpful to control the hemorrhagic tendency while the small dosage had similar effectiveness with large dosage.