甲泼尼龙琥珀酸钠联合复方甘草酸苷治疗儿童重症过敏性紫癜对照研究

A comparative study of methylprednisolone sodium succinate combined with compound glycyrrhizin in the treatment of severe allergic purpura in children

目的探讨甲泼尼龙琥珀酸钠联合复方甘草酸苷治疗对重症过敏性紫癜患儿血清可溶性细胞间黏附分子-1、免疫球蛋白水平的影响。方法将77例重症过敏性紫癜患儿按随机数字表法分为两组,对照组(38例)予以甲泼尼龙琥珀酸钠冲击治疗,研究组(39例)在对照组基础上联合复方甘草酸苷治疗,观察1周。比较两组疗效、不良反应发生率及治疗前后血清免疫球蛋白、T淋巴细胞及可溶性细胞间黏附分子-1、一氧化氮、内皮素-1水平。结果研究组总有效率显著高于对照组(P<0.05);治疗1周末,研究组血清免疫球蛋白A、免疫球蛋白G、CD8^+、可溶性细胞间黏附分子-1、一氧化氮、内皮素-1水平显著低于对照组(P<0.01),血清CD4^+水平显著高于对照组(P<0.01),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论重症过敏性紫癜患儿甲泼尼龙琥珀酸钠联合复方甘草酸苷治疗,疗效确切,能显著改善患儿免疫功能及内皮功能,安全性高。

Objective To investigate the effects of methylprednisolone sodium succinate combined with compound glycyrrhizin on serum soluble intercellular adhesion molecule-1 and immunoglobulin levels in children with severe allergic purpura.Methods 77 children with severe allergic purpura were randomly divided into two groups,and 38 cases in the control group were treated with methylprednisolone sodium succinate for injection impact,and 39 cases in the study group were treated with compound glycyrrhizin on the basis of the control group,patients were observed for 1 week.The curative effect and incidence of adverse reactions of the two groups were analyzed and compared.The levels of serum immunoglobulin,T lymphocytes and sICAM-1,nitric oxide(NO)and endothelin-1(ET-1)were compared between the two groups before and after treatment.Results The total effective rate of the study group was higher than that of the control group(P<0.05).After 1 week of treatment,serum levels of IgA,IgG,CD8^+,sICAM-1,nitric oxide(NO)and endothelin-1(ET-1)in the study group were lower than those in the control group(P<0.05).The serum level of CD4^+ was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Methylprednisolone sodium succinate combined with compound glycyrrhizin treatment is effective in children with severe allergic purpura,and can significantly improve the immune function and endothelial function of children,and has high safety.