丙种球蛋白联合地塞米松治疗小儿特发性血小板减少性紫癜的临床效果

Clinical effect of Gamma Globulin combined with Dexamethasone in the treatment of children with idiopathic thrombocytopenic purpura

目的探讨丙种球蛋白联合地塞米松治疗小儿特发性血小板减少性紫癜的临床效果。方法选取2021年6月至2022年6月济南市济阳区中医医院收治的96例特发性血小板减少性紫癜患儿作回顾性分析,按治疗方案分为参照组(48例,地塞米松治疗)与联合组(48例,丙种球蛋白联合地塞米松治疗)。比较两组临床疗效、血小板计数、外周血T淋巴细胞亚群及不良反应发生情况。结果联合组治疗总有效率高于参照组,差异有统计学意义(P<0.05)。治疗3、7、14 d后,两组血小板计数均较治疗前升高(P<0.05)。但治疗3、7、14d后,两组血小板计数比较,差异无统计学意义(P>0.05)。治疗后,两组CD8^(+)均降低,CD4^(+)、CD3^(+)均升高,且联合组CD8^(+)低于参照组,CD4^(+)、CD3^(+)高于参照组,差异有统计学意义(P<0.05)。联合组不良反应总发生率低于参照组,差异有统计学意义(P<0.05)。结论丙种球蛋白联合地塞米松治疗小儿特发性血小板减少性紫癜的临床效果确切,可改善患儿血小板计数及外周血T淋巴细胞亚群水平,减少不良反应,具有较高的临床推广及应用价值。

Objective To explore the clinical effect of Gamma Globulin combined with Dexamethasone in the treatment of children with idiopathic thrombocytopenic purpura.Methods A retrospective study was conducted in 96 children with idiopathic thrombocytopenic purpura admitted to Jiyang District Traditional Chinese Medicine Hospital,Jinan City from June 2021 to June 2022.All the children were divided into the reference group(48 cases,treated with Dexamethasone)and the combined group(48 cases,treated with Gamma Globulin combined with Dexamethasone)according to the treatment plan.The clinical efficacy,platelet count,T lymphocyte subsets in peripheral blood,and incidence of adverse reactions were compared between the two groups.Results Compared with the reference group,the total effective rate of treatment in the combined group was higher,and the difference was statistically significant(P<0.05).After 3,7,and 14 days of treatment,the platelet counts in both groups increased compared with before treatment(P<0.05).But,after 3,7,and 14 days of treatment,there was no significant difference in platelet count between the two groups(P>0.05).After treatment,CD8^(+)decreased,while CD4^(+)and CD3^(+)increased in both groups,and compared with the reference group,the CD8^(+)was lower,CD4^(+)and CD3^(+)were higher in the combined group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the combined group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion The clinical effect of Gamma Globulin combined with Dexamethasone in the treatment of children with idiopathic thrombocytopenic purpura is definite,which can improve platelet count and the level of T lymphocyte subpopulation in peripheral blood,reduce adverse reactions,and has high clinic al promotion and application value.