糖皮质激素应用于儿童腹型过敏性紫癜中的最佳时机及效果分析

Analysis of the best timing and effect of glucocorticoid in children with abdominal henoch-schonlein purpura

目的分析糖皮质激素应用于儿童腹型过敏性紫癜(HSP)中的最佳时机及效果。方法80例儿童腹型过敏性紫癜患儿,均采用糖皮质激素治疗,按治疗时机及方法的不同分为A组、B组、C组及D组,每组20例。A组实施早期糖皮质激素常规用药,B组实施晚期糖皮质激素常规用药,C组实施早期糖皮质激素快速滴定用药,D组实施晚期糖皮质激素快速滴定用药。比较四组患儿治疗后的各项临床指标、预后情况以及临床治疗效果。结果C组患儿症状缓解时间、激素使用时间短于A组、B组、D组,激素使用量低于A组、B组、D组,差异具有统计学意义(P<0.05)。C组患儿症状反复、消化道严重表现、紫癜性肾炎的发生率明显低于A组、B组、D组,差异具有统计学意义(P<0.05)。C组临床治疗总有效率为95.00%,明显高于A组的65.00%、B组的55.00%、D组的65.00%,差异有统计学意义(P<0.05)。结论采用早期快速滴定糖皮质激素治疗儿童腹型过敏性紫癜患儿,效果显著,能有效缓解患儿的临床症状,缩短患儿治疗时间,减少药物使用量,有助于促进患儿病情加快康复,值得应用。

Objective To analyze the best timing and effect of glucocorticoid in children with abdominal henoch-schonlein purpura(HSP).Methods A total of 80 children with abdominal henoch-schonlein purpura all were treated with glucocorticoids,and they were divided into group A,group B,group C and group D according to different treatment timing and methods,with 20 cases in each group.Group A was treated with early glucocorticoid routine medication,group B was treated with late glucocorticoid routine medication,group C was treated with early titration of glucocorticoid,and group D was treated with late titration of glucocorticoid.The clinical indicators,prognosis and clinical effect after treatment of the four groups were compared.Results The symptom remission time and hormone use time of group C were shorter than those of group A,group B and group D,and hormone use amount was lower than that of group A,group B and group D.All the difference was statistically significant(P<0.05).The incidence of recurrent symptoms,severe gastrointestinal manifestations,purpura nephritis of group C were obviously lower than those of group A,group B and group D,and the difference was statistically significant(P<0.05).The total effective rate of group C was 95.00%,which was obviously higher than 65.00%of group A,55.00%of group B and 65.00%of group D,and the difference was statistically significant(P<0.05).Conclusion Early titration of glucocorticoid has a significant effect on children with abdominal henoch-schonlein purpura,and it can effectively relieve the clinical symptoms of children,shorten the treatment time,reduce the drug use,and help to promote the recovery of children’s condition,which is worthy of application.