糖皮质激素联合丙球蛋白治疗特发性血小板减少性紫癜患儿的临床研究

Clinical effect of glucocorticoid combined with gamma globulin in the treatment of idiopathic thrombocytopenic purpura

目的观察糖皮质激素联合丙球蛋白治疗特发性血小板性紫癜患儿的临床疗效。方法 40例特发性血小板减少性紫癜患儿随机为试验组和对照组,各20例。对照组初期静脉滴注甲泼尼龙5~8 mg·kg^(-1)·d^(-1),血小板计数恢复正常后改为口服泼尼松2 mg·kg^(-1)·d^(-1);试验组在对照组基础上静脉滴注丙球蛋白400 mg·kg^(-1)·d^(-1),2组疗程均为1个月,并随访3个月。比较2组患儿的临床疗效、血小板开始上升时间和血小板到达峰值时间。结果试验组显效率为90.0%,总有效率为95.0%,显著高于对照组的65.0%,85.0%(P<0.05)。试验组血小板开始上升时间和血小板到达峰值时间分别为(3.4±1.6),(8.1±3.1)d,显著短于对照组的(5.0±1.8),(12.9±5.1)d(P<0.05)。2组患儿进行3个月的随访,试验组复发率为0,对照组复发率为46.2%(P<0.01)。结论糖皮质激素联合丙球蛋白的愈后良好,且经济有效。

Objective To investigate the clinical effect of glucocorticoid combined with gamma globulin in the treatment of idiopathic thrombocyto- penic purpura. Methods Forty children with idiopathic thrombocytope- nic purpura were divided into treatment group and control group, 20 ca- ses in each group. Control group was firstly intravenous given methyl- prednisolone 5 -8 mg ·kg-1· d-1, then received oral prednisone 2 mg·kg-1· d-1. On the basis of control group, the treatment group was intravenous given immunoglobulin 400 mg· kg-1· d-1. All patients were treated for 1 month, and followed up for 3 months. The clinical effi- ciency, platelet began to rise time and platelet peak time of the two groups were observed. Results The effective rate and total efficiency of treatment group were 90.0%, 95.0%, significantly higher than those of control group, which were 66. 7%, 85.0% （P 〈0. 05）. The platelet began to rise time and platelet peak time in treatment group were （3.4 ± 1.6）, （8. 1 ± 3.1 ） d, significantly shorter than those in control group, which were （5.0±1.8）, （12.9±5.1） d （P〈0.05）. After3 months follow- up, the recurrence rate in treatment group and control group were 0, 46. 2%, with significant difference （P 〈 0. 01 ）.Conclusion Glucocorticoid combined with gamma globulin in the treat- ment of idiopathic thrombocytopenic purpura was markedly effective.