大剂量丙种球蛋白联合地塞米松治疗免疫性血小板减少性紫癜患儿的临床效果

Clinical effect of high-dose Gamma Globulin combined with Dexamethasone in the treatment of children with immunologic thrombocytopenic purpura

目的探讨大剂量丙种球蛋白联合地塞米松治疗免疫性血小板减少性紫癜(ITP)患儿的临床效果。方法选择湖北省地质职工医院2019年1月至2021年1月收治的71例ITP患儿作为研究对象,根据编号单双数将患者分为观察组(n=36,编号为单数)和对照组(n=35,编号为双数)。对照组采用地塞米松治疗,观察组在对照组的基础上增加大剂量丙种球蛋白治疗,比较两组治疗后的临床疗效及两组治疗前后的CD3^(+)、CD4^(+)CD25^(+)Treg表达水平,同时记录两组治疗前后的血小板计数、血小板计数达峰时间及住院时间。结果观察组治疗后的治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后的CD3^(+)及CD4^(+)CD25^(+)Treg水平高于对照组,差异有统计学意义(P<0.05);观察组治疗后的血小板计数高于对照组,血小板计数达峰时间及住院时间短于对照组,差异有统计学意义(P<0.05)。结论地塞米松联合大剂量丙种球蛋白可提高ITP患儿的治疗效果,能够调节机体免疫功能指标,缩短血小板计数达峰时间,提高血小板计数,缩短患儿住院时间。

Objective To investigate the clinical efficacy of high-dose Gamma Globulin combined with Dexamethasone in the treatment of children with immunologic thrombocytopenic purpura(ITP).Methods A total of 71 children with ITP admitted to Hubei Provincial Geological Staff Hospital from January 2019 to January 2021 were selected as the research objects,and the patients were divided into the observation group(n=36,the number is an odd number)and the control group(n=35,the number is an even number).The control group was treated with Dexamethasone,and the observation group was treated with high-dose Gamma Globulin on the basis of the control group.The clinical efficacy of the two groups after treatment and the expression levels of CD3^(+),CD4^(+)CD25^(+)Treg in the two groups before and after treatment were compared.At the same time,the platelet count,the peak time of platelet count and the length of hospital stay were recorded in the two groups before and after treatment.Results The total effective rate of the observation group after treatment was significantly higher than that of the control group,the difference was statistically significant(P<0.05).The CD3^(+)and CD4^(+)CD25^(+)Treg of the observation group after treatment were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The platelet count of the observation group after treatment was higher than that of the control group,and the peak time of platelet count and the time of hospitalization in the observation group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).Conclusion Dexamethasone combined with high-dose Gamma Globulin can improve the therapeutic effect of children with ITP,and can adjust the body′s immune function indexes,shorten the peak time of platelet count,increase platelet count,and shorten the hospital stay of children.