静脉用丙种球蛋白联合地塞米松治疗儿童免疫性血小板减少症

Intravenous gamma globulin combined with dexamethasone in the treatment of immune thrombocytopenia in children

目的观察静脉用丙种球蛋白联合地塞米松治疗儿童免疫性血小板减少症(ITP)的疗效及预后。方法回顾性分析蚌埠市第一人民医院2013年1月至2017年12月诊断为急性ITP的住院患儿71例,根据治疗方案不同分为观察组(35例)和对照组(36例)。观察组联合静脉用丙种球蛋白及地塞米松治疗,对照组使用地塞米松治疗,分析两组患儿住院期间的治疗效果并追踪患儿出院后3个月内血小板计数的变化情况。结果两组患儿出血部位对比差异无统计学意义(P>0.05)。入院后1 d两组患儿血小板计数比较无统计学差异(P>0.05),经过治疗,入院后3、5 d观察组重型和非重型患儿血小板计数均上升,且显著高于对照组,差异有统计学意义(P<0.01)。两组患儿出院后0.5、1、2、3个月外周血血小板计数,观察组显著高于对照组,差异有统计学意义(P<0.01)。结论静脉用丙种球蛋白联合地塞米松能快速缓解患儿的出血症状,升高血小板计数,对于疾病的复发情况控制良好,整体效果优于单用地塞米松。

Objective To observe the efficacy of intravenous gamma globulin with dexamethasone in the treatment of immune thrombocytopenia(ITP) in children and its prognosis.Methods A retrospective analysis was made on 71 hospitalized children with acute ITP diagnosed in the First People′s Hospital of Bengbu City from January 2013 to December 2017.According to different treatment schemes,they were divided into observation group(n=35) and control group(n=36).The intravenous gamma globulin and dexamethasone was given in observation group,while dexamethasone alone was given in control group.The therapeutic effects during hospitalization were compared between two groups,and the changes of platelet count were tracked within 3 months after discharge.Results There were no significant differences in bleeding sites and platelet count on the 1 st day after admission between two groups(P>0.05).The platelet count in observation group increased on the 3 rd and 5 th day after treatment compared with control group and was significantly higher than that in control group(P<0.01).At 15 days,and 1-,3-and 6-month after discharge,the platelet count in peripheral blood were significantly higher in observation group than those in control group(P<0.01).Conclusion Intravenous gamma globulin combined with dexamethasone can quickly relieve the symptoms of hemorrhage in children with ITP,increase the platelet count and decrease the recurrence of the disease well.The overall effect is better than that of dexamethasone alone.