大剂量注射甲泼尼龙琥珀酸钠治疗小儿重症特发性血小板减少性紫癜的临床疗效与不良反应观察

Clinical Observation of Efficacy and Adverse Reactions of Large Doses Injection of Methylprednisolone Sodium Succinate in the Treatment of Children with Severe Idiopathic Thrombocytopenic Purpura

目的 探讨大剂量注射甲泼尼龙琥珀酸钠治疗小儿重症特发性血小板减少性紫癜的临床疗效与不良反应.方法 选取2012年9月～2014年2月我院收治的80例小儿重症特发性血小板减少性紫癜患儿.随机分为对照组和试验组各40例.对照组给予地塞米松,试验组则给予甲泼尼龙琥珀酸钠大剂量注射治疗,观察两组治疗情况,并统计两组不良反应情况.结果 试验组皮肤紫癜消退时间、腹痛消退时间、关节疼痛消失时间、大便潜血转阴时间分别为45.4±16.0、6.1±3.0、12.0±5.0、67.0-:14.2h,均明显优于对照组的79.6±20.1、17.0±3.9、27.7±6.5、84.4±19.8h,两组比较差异有统计学意义(P＜0.05).两组肾损伤发生率及药物相关不良反应差异并无统计学意义(P＞0.05).结论 在小儿重症特发性血小板减少性紫癜的临床治疗中,给予甲泼尼龙琥珀酸钠大剂量注射可有效缓解患者临床症状,同时具有较高的用药安全性,值得推广应用.

Objective To investigate clinical efficacy and adverse reactions of injection of large doses of methylprednisolone sodium succinate in the treatment of children with severe idiopathic thrombocytopenic purpura. Methods 80 cases of children with severe idiopathic thrombocytopenic purpura patients from September 2012 to February 2014 in our hospital, were randomly divided into two groups, 40 cases of each group. The control group was received dexamethasone, the experimental group was given large doses of methylprednisolone sodium succinate injection therapy.Efficacy and adverse reactions of two groups were observed. Results The experimental group'subsided time of skin purpura, abdominal pain subsided time, joint pain time, clearance time of respondent occult blood were(45.4±16.0),(6.1±3.0),(12.0± 5.0),(67.0±14.2)h, significantly better than the control group((79.6±20.1),(17.0±3.9),(27.7±6.5),(84.4±19.8)h)(P<0.05). The difference had a statistical significance(P>0.05). In the incidence of renal impairment groups and drug-related adverse reactions, difference had no statistical significance(P>0.05). Conclusions In clinical treatment of children with severe idiopathic thrombocytopenic purpura, large injection doses of methylprednisolone sodium succinate can effectively alleviate clinical symptoms, but also hve a high drug safety, be worthy of popularization and application.