双嘧达莫联合甲基强的松治疗小儿过敏性紫癜的疗效观察

Clinical observation of dipyridamole combined with methylprednisolone in treatment of infantile allergic purpura

目的研究双嘧达莫联合甲基强的松治疗小儿过敏性紫癜的临床效果。方法选取2012年8月—2014年8月延安大学附属医院儿科收治的过敏性紫癜患儿80例,随机分为对照组和治疗组,每组各40例。对照组静脉滴注注射用甲泼尼龙琥珀酸钠,第1~3天20 mg/（kg·d）加入到5%葡萄糖溶液150 m L中2 h内滴注完成;以后每3天剂量减半,待患儿病情稳定后改为口服醋酸泼尼松片2.0 mg/（kg·d）,2周后改为1.0 mg/（kg·d）。治疗组在对照组治疗基础上口服双嘧达莫片,3.0 mg/（kg·d）。两组均连续治疗6个月。观察两组的临床疗效,同时比较两组肾损害消失时间、腹痛消失时间、关节肿痛消失时间、消化道出血消退时间、皮疹消退时间、住院时间。结果治疗后,对照组和治疗组的总有效率分别为75.0%、97.5%,两组比较差异有统计学意义（P〈0.05）。治疗组患儿的肾损害消失时间、腹痛消失时间、关节肿痛消失时间、消化道出血消退时间、皮疹消退时间、住院时间均显著短于对照组,两组比较差异具有统计学意义（P〈0.05）。结论双嘧达莫联合甲基强的松治疗小儿过敏性紫癜具有较好的临床疗效,能有效改善患者的临床症状和体征,提高患者治疗的总有效率,具有一定的临床推广应用价值。

Objective To study the clinical effect of dipyridamole combined with methylprednisolone in treatment of infantile allergic purpura. Methods Patients（80 cases） with allergic purpura in Department of Pediatrics of Yanan University Affiliated Hospital from August 2012 to August 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were iv administered with Methylprednisolone Sodium Succinate for injection 20 mg/（kg·d） which was added into 5% glucose solution 150 m L in 2 h for the first day to the third day, and the dosage was in half every 3 d. They were po administered with Prednisone Acetate Tablets 2.0 mg/（kg·d）until the children were in stable condition, and the dosage was 1.0 mg/（kg·d） after two weeks. The patients in the control group were po administered with Dipyridamole Tablets on the basis of the control group, 3.0 mg/（kg·d）. Two groups were treated for six months. After treatment, the efficacy was evaluated, and the changes of kidney damage disappearance time, abdominal pain disappearance time, joint swelling and pain disappeared time, gastrointestinal bleeding subsided time, rash subsided time, and hospital stay time in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 75.0% and 97.5%, respectively, and there were differences between two groups（P 〈 0.05）. After treatment, kidney damage disappearance time, abdominal pain disappearance time, joint swelling and pain disappeared time, gastrointestinal bleeding subsided time, rash subsided time, and hospital stay time in treatment group were shorter than those in the control group, with significant difference between two groups（P 〈 0.05）. Conclusion Dipyridamole combined with methylprednisolone has good clinical curative effect in treatment of infantile allergic purpura, and can effectively improve the clinical symptoms and signs, also can improve the overall efficiency, which has a certain clinical application value.