不同剂量丙种球蛋白联合地塞米松治疗小儿中重症特发性血小板减少性紫癜

Clinical Effects of Gamma Globulin at Different Doses Combined with Dexamethasone in the Treatment of Children with Severe Idiopathic Thrombocytopenic Purpura

目的:探讨不同剂量丙种球蛋白联合地塞米松治疗小儿中重症特发性血小板减少性紫癜(ITP)的疗效。方法:96例ITP患儿随机分为A组(标准大剂量丙种球蛋白+地塞米松)、B组(中剂量丙种球蛋白+地塞米松)和对照组(地塞米松)3组,均连续治疗2周后,比较3组疗效、药品不良反应和治疗前后患儿血小板参数变化情况。结果:A、B两组患儿治疗后Plt、PCT、PDW水平均明显高于对照组(P<0.05),治疗后血小板恢复正常时间和出血停止时间均明显短于对照组(P<0.05),治疗总有效率均明显高于对照组(P<0.05)。A、B两组患儿间治疗后血小板恢复正常时间和出血停止时间,以及治疗总有效率比较,差异均无统计学意义(P>0.05)。三组患儿药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:中剂量丙种球蛋白治疗ITP效果显著,能够达到标准大剂量丙种球蛋白的疗效,且有效减少丙种球蛋白使用剂量,值得临床推广应用。

Objective： To explore the efficacy of gamma globulin at different doses combined with dexamethasone in the treatment of children with severe idiopathic thrombocytopenic purpura. Methods： Totally 96 cases of patients with idiopathic thrombocytopenic purpura were divided into group A（ standard high dose of gamma globulin ＋ dexamethasone）,group B（ middle dose of gamma globulin＋ dexamethasone） and the control group（ dexamethasone）. The clinical effects and platelet parameters of the three groups were compared. Results： The levels of PLT,PCT and PDW in group A and group B after the treatment were higher than those in the control group（ P 〈0. 05）. The recovery time of normal platelet and the stop time of bleeding in group A and group B were lower than those in the control group（ P 〈0. 05）,and there was no significant difference between group A and group B（ P 〉0. 05）. The clinical effective rate of group A and group B was higher than that in the control group（ P 〈0. 05）,and there was no significant difference between group A and group B（ P 〉0. 05）. There was no significant difference in the incidence of adverse reactions among the three groups（ P 〉0. 05）. Conclusion： Gamma globulin at middle dose shows significant effect as at high dose in the patients with ITP,which can reduce the dosage and is worthy of clinical promotion.