特发性血小板减少性紫瘢患儿治疗后末梢血血小板数和骨髓巨核细胞数的变化  

The change in Number of Platelet and Megalokaryocyte in Children with Idiopathic Thrombocytopenic Purpura after Treatment

作　　者：曾毓华[1] 严健[1] 钟小红[1] 梁昌达[1] 

机构地区：[1]江西省儿童医院血液科,江西南昌330006

出　　处：《江西医学院学报》2004年第4期53-55,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的　观察大剂量低PH人血丙球蛋白 (IVIG)加地塞米松冲击治疗特发性血小板减少性紫瘢 (ITP)后 ,观察末梢血血小板数和骨髓巨核细胞的变化。方法　经临床确诊了的ITP患儿 30例用成都生物制品研究所生产的IVIG4 0 0mg/kg·d-1静点 ,连用 5d ,同时加用地塞米松 0 .5～ 1mg/kg·d-1冲击治疗 ,分别在治疗后第 2、4、6、8天测定末梢血血小板数的变化 ,于治疗第 8天观察骨髓巨核细胞数。并设单用地塞米松治疗组进行对照。结论　治疗组在治疗后第 2、4、6d末梢血血小板数明显高于对照组。骨髓巨核细胞总数、幼巨核细胞数、颗粒型巨核细胞数和过巨型、裸核型巨核细胞数在治疗后明显减少 ,以颗粒型巨核减少为主 ,P <0 .0 1,有显著性差异。而且观察到在治疗第 8天产血小板巨核细胞增多。结论　IVIG加地塞米松冲击治疗小儿ITP末梢血血小板上升快 ,治疗后 2d血小板平均可升至 190× 10 9/L。本疗法是治疗高危ITP患儿 ,防止重要脏器出血 ,降低死亡的一种重要的治疗方法。Objective To observe the change in the number of platelet megalokaryocyte in children with idiopathic thrombocytopenic purpura(ITP)after treated with high dose of low PH gama globulin(IVIG) plus dexamethasone impacting.Methods The therapy group included 30 cases of ITP's patients treated with IVIG 400 mg/kd·d -1 ,qd×5 d(Chendu Biological Institute)and dexamethasone 1～1.5 mg/kd·d -1 impacting.Control group was treated with only dexamethasone.The number of platelet in blood were respectively counted on the 2th、4th、6th and 8th day after treatment.The number of meglokaryocyte in bone marrow were counted on the 8th day.Results The number of platelet in children with IVIG was obviously higher than that in children without IVIG(P<0.01).The numbers of megalokaryocytes.early-megalokaryocytes、naked megalokaryoytes and megalokaryoblasts,especially the later were singificantly lower than that control group(P<0.001),while mature megalokaryocytes were increased on the 8th day in the therapy group.Conclusion IVIG plus dexamethasone impacting is an effective treatment for ITP’s patients,which would result in an increasing number of platelet early,and could prevent the main organs from bleeding and decrease the death rate of ITP children at high risk.

关 键 词：特发性血小板减少性紫瘢 血小板 巨核细胞 对比研究 

分 类 号：R558.2[医药卫生—血液循环系统疾病]