糖皮质激素治疗过敏性紫癜临床疗效及血清sVCAM-1和LTB4水平变化研究  

Clinical efficacy of glucocorticoid in allergic purpura and level change of s VCAM- 1,LTB4

作　　者：张冷[1] 刘智[1] 

机构地区：[1]荆门市第一人民医院新生儿科,湖北荆门448000

出　　处：《临床和实验医学杂志》2016年第9期873-875,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察糖皮质激素治疗过敏性紫癜的临床疗效及血清可溶性血管细胞黏附分子-1（sVCAM-1）、白细胞三烯B4（LTB4）水平的变化。方法将2010年1月至2015年6月收治的87例过敏性紫癜患者随机分为对照组和治疗组两组,所有患者在住院后均给予常规的抗组胺药物、维生素C、肾上腺色腙片、丹参、钙剂等抗过敏治疗,治疗期间停服可能引发过敏的食物及药物等过敏源,治疗组在上述基础上给予氢化可的松。观察两组临床疗效和治疗前后s VCAM-1、LTB4水平。结果治疗组治愈36例,有效7例,无效1例,治疗组治愈率为81.82%,总有效率97.73%;对照组治愈11例,有效14例,无效18,对照组治愈率为25.58%,总有效率为58.14%。治疗组总有效率明显高于对照组,差异有显著性（χ^2=4.32,P〈0.05）。两组患者治疗后sVCAM-1,LTB4水平均显著降低,差异有统计学意义（P〈0.05）,治疗组与对照组比较改善更显著,两组比较有统计学意义（P〈0.05）。治疗后5个月随访,所有患者均无肾功能不全、肝功能异常、严重感染等不良反应。结论糖皮质激素治疗可以有效改善过敏性紫癜患者的临床症状,其机制可能是通过阻断血管内皮细胞与白细胞之间的作用位点,有效抑制炎症的发生。Objective To investigate glucocorticoid for allergic purpura and levels changes of sVCAM- 1,LTB4. Methods From January 2010 to June 2015,87 patients of allergic purpura in our hospital were randomly divided into control and experimental groups. All patients were administered antihistamines,vitamin C,carbazochrome,salvia,calcium. stop contacted food and drug which may lead to allergy. The experimental group received hydrocortisone based on the above. Clinical efficacy was observed in two groups and the levels change of sVCAM- 1,LTB4 were tested before and after treatment. Results The total efficiency of experimental group was 97. 73% and control group was 58. 14%（ χ^2= 4.32,P〈0. 05）. The level of s VCAM- 1,LTB4 declined after treatment in two groups（ P〈0. 05） and the experimental group improved more significantly than control group（ P〈0. 05）. Nobody complained of renal insufficiency,hepatic dysfunction and severe infection after five months follow- up. Conclusion Glucocorticoid improve clinical symptoms of allergic purpura effectively,which block vascular endothelial cells and leukocytes and then inhibit inflammation.

关 键 词：过敏性紫癜 氢化可的松 SVCAM-1 LTB4 

分 类 号：R554.6[医药卫生—血液循环系统疾病]