研究甲泼尼龙治疗小儿过敏性紫癜消化道出血的效果以及对肾功能的影响

Study of the Effect of Methylprednisolone in the Treatment of Gastrointestinal Bleeding in Pediatric Allergic Purpura and the Effect on Renal Function

目的对比分析小儿过敏性紫癜消化道出血治疗中甲泼尼龙的应用效果及其对患儿肾功能的影响。方法选择2020年2月—2021年5月在苏州市相城人民医院进行治疗的96例过敏性紫癜消化道出血患儿为研究对象。根据电脑随机分组法将其分为对照组和观察组,每组48例。对照组采取氢化可的松治疗,观察组采取甲泼尼龙治疗。比较分析两组肾功能指标变化、治疗总有效率、炎性因子水平变化及用药后不良反应发生率。结果观察组治疗后ALB、24 h尿蛋白定量、红细胞计数分别为(18.76±3.52)μg/min、(0.23±0.06)g/24 h、(45.37±8.87)个/HP,低于对照组,差异有统计学意义(t=5.690,14.091,4.914,P<0.05)。观察组治疗总有效率为95.83%,明显高于对照组的83.33%,差异有统计学意义(χ^(2)=4.018,P<0.05)。治疗后,观察组IL-6水平为(23.47±5.22)g/L、IL-10水平为(43.16±8.43)g/L、TNF-α为(54.17±6.86)g/L,均低于对照组,差异有统计学意义(t=2.781,5.266,7.493,P<0.05)。观察组不良反应发生率为4.17%,低于对照组的18.75%,差异有统计学意义(χ^(2)=5.031,P<0.05)。结论在治疗小儿过敏性紫癜消化道出血中应用甲泼尼龙效果显著,可有效降低患儿炎性因子水平,保护其肾功能,不良反应较少,用药安全性高。

Objective To compare and analyze the effect of methylprednisolone in the treatment of gastrointestinal hemorrhage in children with allergic purpura and its effect on renal function.Methods A total of 96 children with anaphylactoid purpura with gastrointestinal bleeding who were treated in the Suzhou Xiangcheng People's Hospital from February 2020 to May 2021 were selected as the research subjects.They were divided into control group and observation group according to computer random grouping method,48 cases in each group.The control group was treated with hydrocortisone,and the observation group was treated with methylprednisolone.The changes of renal function indexes,the total effective rate of treatment,the changes of inflammatory factor levels and the incidence of adverse reactions after medication were compared and analyzed between the two groups.Results ALB,24 h urine protein quantification and red blood cell count in the observation group after treatment were(18.76±3.52)μg/min,(0.23±0.06)g/24 h,and(45.37±8.87)cells/HP,respectively,which were lower than those in the control group,the difference was statistically significant(t=5.690,14.091,4.914,P<0.05).The total effective rate of the observation group was 95.83%,which was significantly higher than that of the control group 83.33%,and the difference was statistically significant(χ^(2)=4.018,P<0.05).After treatment,the level of IL-6 in the observation group was(23.47±5.22)g/L,the level of IL-10 was(43.16±8.43)g/L,and the level of TNF-α was(54.17±6.86)g/L,all of which were lower in the control group,the difference was statistically significant(t=2.781,5.266,7.493,P<0.05).The incidence of adverse reactions in the observation group was 4.17%,which was lower than 18.75% in the control group,and the difference was statistically significant(χ^(2)=5.031,P<0.05).Conclusion The application of methylprednisolone in the treatment of gastrointestinal bleeding in children with allergic purpura has a significant effect,can effectively reduce the level of inflammatory factors in children,protect their renal function,less adverse reactions,and high drug safety.