甲基强的松龙治疗小儿过敏性紫癜的效果及对血清炎性因子、免疫功能及凝血功能的影响

Effect of methylprednisolone in the treatment of children with allergic purpura and its influence on serum inflammatory factors, immune function and coagulation function

目的分析甲基强的松龙治疗小儿过敏性紫癜的效果及对患儿血清炎性因子、免疫功能与凝血功能的影响。方法选择2015年1月至2017年10月在我院接受治疗的80例过敏性紫癜患儿作为研究对象,根据入院顺序单双号分为对照组和观察组,每组40例。对照组患儿接受常规治疗,观察组患儿在对照组基础上接受甲基强的松龙治疗。比较两组患儿临床症状消失时间、血清炎性因子、免疫功能、凝血功能变化情况及临床疗效。结果治疗后,观察组患儿腹痛、呕吐、便血和皮疹等临床症状消失时间明显短于对照组(P<0.05);治疗后,两组患儿TNF-α、IgA、IL-10水平均降低,且观察组明显低于对照组,差异有统计学意义(P<0.05);两组患儿CD3^+、CD4^+水平和CD4^+/CD8^+均升高,且观察组明显高于对照组(P<0.05);两组患儿CD8^+水平均降低,但差异无统计学意义(P>0.05);两组患儿APTT和PT显著延长,FIB水平显著下降,且观察组患儿APTT和PT显著长于对照组,FIB水平显著低于对照组(P<0.05);观察组的治疗总有效率为90.00%,显著高于对照组的67.50%(P<0.05)。结论常规治疗联合甲基强的松龙治疗小儿过敏性紫癜效果显著,可有效降低患儿炎性因子水平,改善免疫功能和凝血功能,值得临床推广应用。

Objective To analyze the effect of methylprednisolone in the treatment of children with allergic purpura and its influence on serum inflammatory factors,immune function and coagulation function.Methods Eighty children with allergic purpura treated in our hospital from January 2015 to October 2017 were enrolled in the study.According to the order of admission,they were divided into control group and observation group,with 40 cases each group.The children in the control group received routine treatment,and the children in the observation group received methylprednisolone treatment on the basis of the control group.The disappearance time of clinical symptoms,changes of serum inflammatory factors,immune function,coagulation function and clinical efficacy were compared between the two groups.Results After treatment,the disappeared time of clinical symptoms such as abdominal pain,vomiting,bloody stools and rash symptoms of the observation group were significantly shorter than those of the control group(P<0.05);the levels of TNF-α,IgA,IL-10 in the two groups significantly decreased,and those in the observation group were significantly lower than the control group(P<0.05);the levels of CD3^+,CD4^+and CD4^+/CD8^+in the two groups significantly increased,and those in the observation group were significantly higher than the control group(P<0.05),the levels of CD8+decreased in both groups,but there were no significant differences(P>0.05);the APTT and PT significantly prolonged in both groups,and those of the observation group were significantly longer than the control group(P<0.05);the levels of FIB decreased in both groups,and that of the observation group was significantly lower than the control group(P<0.05).The total effective rate of treatment in the observation group was 90.00%,which was significantly higher than 67.50%in the control group(P<0.05).Conclusion Routine therapy combined with methylprednisolone is effective in treating children with allergic purpura,which can effectively decrease the levels of inflammatory factors,improve immune function and coagulation function,which is worthy of clinical promotion and application.