血液灌流治疗儿童重症腹型过敏性紫癜的临床疗效分析

Clinical Efficacy of Hemoperfusion in the Treatment of Severe Abdominal Allergic Purpura in Children

目的:探讨采用血液灌流对儿童重症腹型过敏性紫癜进行治疗的临床效果。方法:选取2013年8月至2018年3月期间重症腹型过敏性紫癜患儿28例,按照治疗方法的不同将其分为观察A组(血液灌流)和观察B组(常规治疗),另选取健康儿童14例作为健康对照组,对三组入选儿童治疗前后血清肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、血浆丙二醛(MDA)、超氧化物歧化酶(SOD)、血浆总抗氧化能力(T-AOC)水平进行测定。结果:观察A组患儿治疗后其MDA、TNF-α、IL-6水平均明显低于观察B组,T-AOC、SOD水平均明显高于观察B组,差异具有显著性(P<0.05);观察A组患儿皮疹、消化道症状消失时间均明显短于观察B组,差异具有显著性(P<0.05);观察A组患儿随访期间腹痛/皮疹复发率和肾损害发生率均明显低于观察B组,其激素日平均用量明显低于后者,差异具有显著性(P<0.05)。结论:对于儿童重症腹型过敏性紫癜,在常规治疗基础上联合血液灌流,可有效提高对于机体炎症介质、氧化应激产物的清除效果,对于恢复机体免疫机制和氧化作用平衡对于十分积极的意义,有利于增强临床治疗效果,减轻患儿痛苦,建议在临床推广应用。

Objective:To investigate the clinical effect of blood perfusion on children with severe abdominal allergic purpura.Methods:28 children with severe abdominal allergic purpura were enrolled in our hospital from August 2013 to March 2018.They were divided into observation group A(blood perfusion)and observation group B according to different treatment methods.Treatment),another 14 healthy children were selected as healthy control group,serum tumor necrosis factor(TNF-α),interleukin-6(IL-6),plasma malondialdehyde(MDA),superoxide before and after treatment in three groups of children.The level of dismutase(SOD)and total plasma antioxidant capacity(T-AOC)were measured.Results:The levels of MDA,TNF-αand IL-6 in group A were significantly lower than those in group B.The levels of T-AOC and SOD were significantly higher than those in group B.The difference was significant(P<0.05).The incidence of rash and gastrointestinal symptoms disappeared significantly in group A,and the difference was significant(P<0.05).The incidence of abdominal pain/rash recurrence and renal damage during follow-up were observed in group A.Compared with the observation group B,the average daily dose of hormone was significantly lower than the latter,and the difference was significant(P<0.05).Conclusion:For children with severe abdominal allergic purpura,combined with blood perfusion on the basis of conventional treatment,can effectively improve the clearance of inflammatory mediators and oxidative stress products,and is very positive for restoring the immune mechanism and oxidation balance of the body.It is conducive to enhancing the clinical treatment effect and reducing the pain of children.It is recommended to be applied in clinical practice.