不同剂量丙种球蛋白治疗儿童特发性血小板减少性紫癜的临床疗效及安全性研究  

Study on clinical efficacy and safety of different doses of gamma globulin in the treatment of children with idiopathic thrombocytopenic purpura

作　　者：刘兰海 LIU Lan-hai(Department of Pediatrics,Ju County People's Hospital,Rizhao 276500,China)

机构地区：[1]山东省日照市莒县人民医院儿科,276500

出　　处：《中国实用医药》2024年第1期35-38,共4页China Practical Medicine

摘　　要：目的探讨儿童特发性血小板减少性紫癜(ITP)应用不同剂量丙种球蛋白治疗的临床疗效及安全性。方法84例ITP患儿,采用随机数字表法分为观察组与对照组,各42例。对照组予以地塞米松+大剂量丙种球蛋白治疗,观察组予以地塞米松+小剂量丙种球蛋白治疗。比较两组临床疗效,治疗前后的血小板参数、免疫功能、炎症因子,恢复情况、不良反应发生情况。结果观察组治疗总有效率为90.48%,与对照组的95.24%比较,差异无统计学意义(P>0.05)。治疗后,两组血小板压积(PCT)、血小板计数(PLT)、血小板分布宽度(PDW)、血小板平均体积(MPV)均高于治疗前,差异有统计学意义(P<0.05);两组治疗后的PCT、PLT、PDW、MPV组间比较,差异无统计学意义(P>0.05)。治疗后,两组免疫球蛋白(Ig)G、IgM、IgA均高于治疗前,差异有统计学意义(P<0.05);两组治疗后的IgG、IgM、IgA组间比较,差异无统计学意义(P>0.05)。治疗后,两组肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-4、IL-6均低于治疗前,差异有统计学意义(P<0.05);两组治疗后TNF-α、IL-4、IL-6组间比较,差异无统计学意义(P>0.05)。两组PLT恢复正常时间、出血停止时间比较,差异无统计学意义(P>0.05)。观察组不良反应发生率为4.76%,与对照组的9.52%比较,差异无统计学意义(P>0.05)。结论儿童ITP应用不同剂量丙种球蛋白治疗效果相当,均可改善血小板参数及免疫功能,降低TNF-α、IL-4、IL-6水平,促进疾病恢复,且安全性较好,而小剂量丙种球蛋白可明显减轻医疗负担,更值得推广。Objective To investigate the clinical efficacy and safety of different doses of gamma globulin in the treatment of idiopathic thrombocytopenic purpura(ITP)in children.Methods 84 patients with ITP were divided into an observation group and a control group by random number table method,with 42 patients in each group.The control group was treated with dexamethasone+high-dose gamma globulin,and the observation group was treated with dexamethasone+low-dose gamma globulin.The clinical efficacy,platelet parameters,immune function and inflammatory factor level before and after treatment,recovery,and adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation group(90.48%)and control group(95.24%)was compared,and the difference was not statistically significant(P>0.05).After treatment,the plateletcrit(PCT),platelet count(PLT),platelet distribution width(PDW),mean platelet volume(MPV)of the two groups were higher than those before treatment,and the difference was statistically significant(P<0.05).After treatment,PCT,PLT,PDW and MPV were compared between the two groups,and the difference was not statistically significant(P>0.05).After treatment,the immunoglobulin(Ig)G,IgM and IgA were higher than those before treatment,and the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in IgG,IgM and IgA between the two groups(P>0.05).After treatment,the tumor necrosis factor-α(TNF-α),interleukin(IL)-4 and IL-6 of the two groups were lower than those before treatment,and the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in of TNF-α,IL-4 and IL-6 between the two groups(P>0.05).The PLT recovery time and bleeding stop time of the two groups were not statistically significant(P>0.05).The incidence of adverse reactions in the observation group was 4.76%,which had no statistically significant difference compared with 9.52%in the control group(P>0.05)

关 键 词：特发性血小板减少性紫癜 儿童 丙种球蛋白 地塞米松 血小板参数 免疫功能 炎症抑制水平 安全性 

分 类 号：R725.5[医药卫生—儿科]