不同剂量丙种球蛋白联合糖皮质激素治疗小儿特发性血小板减少性紫癜的临床观察

Clinical effects for the patients with child idiopathic thrombocytopenic purpura by different doses of gamma globulin combined hormone therapy

目的:探讨不同剂量丙种球蛋白联合糖皮质激素治疗小儿特发性血小板减少性紫癜(ITP)的临床疗效。方法:选取2012年9月—2015年1月收治的93例ITP患儿,按照入院顺序随机均分为观察组A、观察组B和对照组。对照组采取卡巴克洛、维生素K1等支持治疗,静脉滴注地塞米松,治疗5 d后,口服泼尼松治疗。观察组A在对照组的基础上,给予丙种球蛋白400 mg·kg-1·d-1,观察组B在对照组的基础上,给予丙种球蛋白200 mg·kg-1·d-1治疗,观察患儿血小板开始上升时间、血小板上升至正常时间、治疗效果、并发症发生情况。结果:观察组A和观察组B血小板开始上升时间、血小板上升至正常时间比较,差异无统计学意义(P>0.05);观察组A和观察组B血小板开始上升时间、血小板上升至正常时间均低于对照组,差异有统计学意义(P<0.05)。观察组A和观察组B治疗总有效率比较,差异无统计学意义(P>0.05);观察组A和观察组B治疗总有效率均高于对照组,差异有统计学意义(P<0.05)。观察组A并发症发生率高于观察组B和对照组,差异有统计学意义(P<0.05);观察组B并发症发生率与对照组比较,差异无统计学意义(P>0.05)。结论:低剂量丙种球蛋白联合糖皮质激素治疗小儿ITP的临床疗效和高剂量临床疗效相当,均能够缩短血小板开始上升时间、血小板上升至正常时间,而且低剂量时患儿并发症发生率较低,临床应用价值较高。

Objective：To explore the clinical effects for the patients with child idiopathic thrombocytopenic purpura by different doses of gamma globulin combined hormone therapy.Methods：All 93 cases of patients with child idiopathic thrombocytopenic purpura were randomly divided into experiment group A,experiment group B and control group,the control group were treated by carbazochrome salicylate,vitamin K1,dexamethasone,prednisone.On the basis of the control group,the experiment group A were treated by high dose immunoglobulin,the control group were treated by low dose immunoglobulin,the platelet began to rise time,platelet rose to normal time,therapeutic effect and complications were observed.Results：There had no significant difference on the platelet began to rise time,platelet rose to normal time for the experiment group A and experiment group B（P〉0.05）.The platelet began to rise time,platelet rose to normal time for the experiment group A and experiment group B were lower than the control group（P〈0.05）.There had no significant difference on the clinical effects for the experiment group A and experiment group B（P〉0.05）.The clinical effects for the experiment group A and experiment group B were higher than the control group（P〈0.05）.The rate of complication for the experiment group A were higher than the experiment group B and control group（P〈0.05）.The rate of complication for the experiment group B was same as the control group（P〈0.05）.Conclusion：It has clinical curative effect quite for the patients with child idiopathic thrombocytopenic purpura by different doses of gamma globulin combined hormone therapy,it can reduce the platelet began to rise time,platelet rose to normal time,it has low rate of complication with low dose immunoglobulin,it has high values of clinical application.