甲泼尼龙联合丙种球蛋白治疗儿童急性特发性血小板减少性紫癜的临床疗效观察

Clinical curative effect observation of methylprednisolone combined with gamma globulin in the treatment of children with acute idiopathic thrombocytopenic purpura

目的:观察甲泼尼龙联合丙种球蛋白治疗急性特发性血小板减少性紫癜的疗效及其对血TNF-α及IL-4的影响,探讨急性特发性血小板减少性紫癜治疗方法及机制。方法:将65例急性特发性血小板减少性紫癜患儿随机分为联合治疗组30例及对照组33例。对照组给予丙种球蛋白静脉滴注,治疗组在对照组的基础上给予甲泼尼龙静脉滴注。对比两组患儿的临床疗效,检测治疗前及治疗后14 d血TNF-α及IL-4浓度。结果:治疗组总有效率明显高于对照组(P<0.05);与治疗前比较,治疗后两组血TNF-α明显降低、IL-4明显升高(P<0.05),治疗后治疗组血TNF-α、IL-4改善明显优于对照组(P<0.05)。结论:甲泼尼龙联合丙种球蛋白治疗儿童急性特发性血小板减少性紫癜能更好地改善患儿的临床症状,显著降低血TNF-α、升高IL-4,调节患儿的免疫功能,减少血小板破坏,缓解患儿病情。

Objective:To observe the curative effect of methylprednisolone combined with gamma globulin in the treatment ofacute idiopathic thrombocytopenic purpura and the effect of TNF-αand IL-4,to explore the treatment method and mechanism ofacute idiopathic thrombocytopenic purpura.Methods:65 children with acute idiopathic thrombocytopenic purpura were randomlydivided into the treatment group with 30 cases and the control group with 33 cases.The control group was given gamma globulinintravenous drip.The treatment group was given methylprednisolone intravenous drip on the basis of the control group.The clinicalcurative effects of two groups were compared.The concentrations of TNF-αand IL-4 were detected before treatment and 14 daysafter the treatment.Results:The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).Compared with before treatment,the TNF-α of two groups after treatment were significantly decreased,and IL-4 weresignificantly higher(P<0.05).The improvements of TNF-α and IL-4 in treatment group after treatment were significantly betterthan those of the control group(P<0.05).Conclusion:Methylprednisolone combined with gamma globulin in the treatment ofchildren with acute idiopathic thrombocytopenic purpura can better improve the clinical symptoms of children,significantlyreduce the blood TNF-α,increase IL-4,regulate the immune function of children,reduce the platelet damage, and relief thechildren's condition.