亚标准剂量丙种球蛋白联合地塞米松治疗儿童特发性血小板减少性紫癜的临床研究  

Clinical Study of Sub-standard Dosage of Gamma Globulin in Combination with Dexamethasone in Idiopathic Thrombocytopenic Purpura in Children

作　　者：杨玉湘[1] 

机构地区：[1]凉山州第一人民医院儿科,四川凉山615000

出　　处：《四川医学》2015年第7期1026-1028,共3页Sichuan Medical Journal

摘　　要：目的探讨亚标准剂量丙种球蛋白联合地塞米松治疗儿童特发性血小板减少性紫癜(ITP)的临床疗效及安全性。方法选择符合标准的患儿67例,随机分为观察组34例和对照组33例,观察组采用亚标准剂量丙种球蛋白联合地塞米松治疗,对照组采用标准剂量丙种球蛋白联合地塞米松治疗,比较临床治疗效果。结果治疗前两组患儿血小板计数相似,差异无统计学意义(P>0.05);治疗3、7和14d,两组患儿血小板计数较治疗前均上升,差异有统计学意义(P<0.05),但是二者上升幅度相似,差异无统计学意义(P>0.05)。观察组患儿出血症状控制时间(3.79±0.44)d、住院时间(12.36±2.42)d;对照组患儿出血症状控制时间(3.70±0.41)d、住院时间(12.13±2.38)d;二者比较均无统计学差异(P<0.05)。观察组治愈26例(76.48%)、显效4例(11.76%)、有效3例(8.82%)和无效1例(2.94%);对照组治愈27例(81.82%)、显效3例(9.09%)、有效2例(6.06%)和无效1例(3.03%);差异无统计学意义(P>0.05)。观察组不良反应发生率11.76%,与对照组15.15%相似,差异无统计学意义(P>0.05)。结论亚标准剂量或标准剂量丙种球蛋白联合地塞米松治疗ITP临床疗效相似,均可显著改善患儿临床症状,安全性高。Objective To investigate the clinical efficacy and safety of sub-standard dosage of gamma globulin in combination with dexamethasone in idiopathic thrombocytopenic purpura（ ITP） in children. Methods Sixty-seven elective children who met the criteria were divedrandomly into observation group（ n = 34） and control group（ n = 33）. Both groups were treated with substandard and standard dosages of gamma globulin in combination with dexamethasone,respectively. Clinical therapeutic effects were compared. Results Platelet count no statistically significant difference betueen two groups before treatment.（ P〉0. 05）. At days 3,7 and 14 after treatment,platelet count increased in both groups compared with pretreatment,with a statistically significant difference（ P〈0. 05）. In the observation group mean duration of hemorrhagic symptom control and hospital stays were（ 3. 79±0. 44） d and（ 12. 36±2. 42） d,respectively,versus control group [（ 3. 70±0. 41） d and（ 12. 13±2. 38） d,respectively]; no statistical difference was noted between two groups. In the observation group,27 patients（ 76. 48%） cured,four（ 11. 76%） markedly improved,three effective（ 8. 82%） and one ineffective（ 2. 94%）,versus control group [27（ 81. 82%）,3（ 9. 09%）,2（ 6. 06%）,1（ 3. 03%） ],with no statistically significant difference（ P〉0. 05）. Conclusion Clinical efficacy is similar between the treatment of ITP with either standard or sub-standard dosage of gamma globulin in combination with dexamethasone because of their marked improvement in clinical symptoms in children with high safety.

关 键 词：特发性血小板减少性紫癜 丙种球蛋白 地塞米松 亚标准剂量 

分 类 号：R725.5[医药卫生—儿科]