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激素联合不同剂量丙种球蛋白治疗儿童特发性血小板减少性紫癜的效果研究

Study on the Effect of Hormone Combined with Different Doses of Gamma Globulin in the Treatment of Idiopathic Thrombocytopenic Purpura in Children
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摘要 目的探讨激素联合不同剂量丙种球蛋白治疗儿童特发性血小板减少性紫癜(ITP)的效果。方法方便选取2020年5月-2021年4月于该院就诊的ITP患儿92例为研究对象,以随机数表法将其划分为两组。对照组46例应用常规剂量400 mg/kg丙种球蛋白治疗,研究组46例应用优化剂量200 mg/kg丙种球蛋白治疗。比较两组患儿的临床疗效,治疗前后血小板平均体积、血小板计数、血小板压积、血小板分布宽度,以及血小板恢复正常时间、出血停止时间、医疗费用、不良反应情况。结果研究组总有效率91.30%与对照组93.48%对比,差异无统计学意义(χ^(2)=0.000,P>0.05)。治疗后,研究组血小板平均体积(10.98±3.03)fl、血小板计数(270.52±55.00)×10^(9)/L、血小板压积(3.25±1.52)%、血小板分布宽度(21.03±4.52)%,高于治疗前(9.35±2.52)fl、(20.10±5.03)×10^(9)/L、(1.62±1.02)%、(12.85±4.65)%,差异有统计学意义(t=2.805、30.752、6.039、8.555,P<0.05),与同期对照组(11.05±2.46)fl、(272.69±56.79)×10^(9)/L、(3.30±1.74)%、(22.03±3.98)%对比,差异无统计学意义(t=0.122、0.186、0.147、1.126,P>0.05)。研究组血小板恢复正常时间(5.85±1.52)d、出血停止时间(3.90±1.45)d与对照组(5.76±1.80)、(3.88±1.37)d对比,差异无统计学意义(t=0.259、0.068,P>0.05);研究组医疗费用(5310.52±180.45)元较对照组(7246.52±265.47)元低,差异有统计学意义(t=40.906,P<0.05)。研究组不良反应发生率4.35%与对照组8.70%对比,差异无统计学意义(χ^(2)=0.178,P>0.05)。结论激素联合不同剂量丙种球蛋白治疗儿童ITP的效果相当,但优化剂量(200 mg/kg)丙种球蛋白方案能够有效节省治疗费用,缓解患儿家庭的经济负担。 Objective To investigate the effect of hormone combined with different doses of gamma globulin in the treatment of idiopathic thrombocytopenic purpura(ITP)in children.Methods 92 children with ITP treated in the hospital from May 2020 to April 2021 were conveniently selected as the research objects.They were divided into two groups by a random number table method.46 cases in the control group were treated with the conventional dose of 400 mg/kg gamma globulin,and 46 cases in the study group were treated with the optimized dose of 200 mg/kg gamma globulin.The clinical efficacy of the two groups of patients was compared,the average platelet volume,platelet count,platelet hepatic volume,platelet distribution width before and after treatment,as well as the time of platelet recovery to normal,the time of stopping bleeding,medical expenses,and adverse reactions.Results The total effective rate of the study group was 91.30% compared with 93.48% of the control group,and the difference was not statistically significant(χ^(2)=0.000,P>0.05).After treatment,The mean platelet volume(10.98±3.03)fl,platelet count(270.52±55.00)×10^(9)/L,platelet hematocrit(3.25±1.52)%,platelet distribution width(21.03±4.52)%in the study group were higher than those before treatment(9.35±2.52)fl,(20.10±5.03)×10^(9)/L,(1.62±1.02)%,(12.85±4.65)%,the difference was statistically significant(t=2.805,30.752,6.039,8.555,P<0.05).There was no statistically significant difference compared with the control group at the same time(11.05±2.46)fl,(272.69±56.79)×10^(9)/L,(3.30±1.74)%,(22.03±3.98)%(t=0.122,0.186,0.147,1.126,P>0.05).There were no statistically significant differences in platelet recovery time(5.85±1.52)d and bleeding stop time(3.90±1.45)d between the study group and the control group(5.76±1.80)d and(3.88±1.37)d(t=0.259,0.068,P>0.05).The medical cost of the study group(5310.52±180.45)yuan was lower than that of the control group(7246.52±265.47)yuan,and the difference was statistically significant(t=40.906,P<0.05).The incidence of adverse reactions in study group was 4.35% compared with 8.70%in control group,and the difference was not statistically significant(χ^(2)=0.178,P>0.05).Conclusion The effect of hormone combined with different doses of gamma globulin in the treatment of children with ITP is equivalent,but the optimized dose(200 mg/kg)gamma globulin regimen can effectively save treatment costs and alleviate the economic burden of children's families.
作者 季丽娟 JI Lijuan(Department of Pediatrics,Zibo Maternity and Child Health Hospital,Zibo,Shandong Province,255000 China)
出处 《中外医疗》 2022年第5期5-8,共4页 China & Foreign Medical Treatment
关键词 激素 丙种球蛋白 儿童 特发性血小板减少 紫癜 Hormones Gamma globulin Children Idiopathic thrombocytopenia Purpura
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