地塞米松联合不同剂量丙种球蛋白治疗重症免疫性血小板减少性紫癜患儿的临床疗效分析  

Clinical effect analysis of dexamethasone combined with different doses of gamma globulin in the treatment of children with severe immune thrombocytopenic purpura

作　　者：张汉清 ZHANG Han-qing(Pediatric Intensive Care Unit,Putian Children's Hospital,Putian University Affiliated Hospital Medical Group,Putian 351100,China)

机构地区：[1]莆田学院附属医院医疗集团莆田市儿童医院儿童重症监护室,351100

出　　处：《中国现代药物应用》2024年第9期116-119,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨地塞米松联合不同剂量丙种球蛋白在重症免疫性血小板减少性紫癜(ITP)患儿中的临床治疗效果。方法选取104例重症ITP患儿为研究对象,采用简单化随机法将患儿分为对照组(52例)和观察组(52例)。对照组患儿采用地塞米松联合小剂量(400 mg)丙种球蛋白进行治疗,观察组患儿采用地塞米松联合大剂量(800 mg)丙种球蛋白进行治疗。比较两组患儿的临床疗效、住院时间、血小板计数及不良反应发生率。结果观察组患儿的临床总有效率(98.1%)高于对照组(86.5%)(P<0.05)。观察组患儿的住院时间(6.35±0.67)d短于对照组的(11.23±1.15)d(P<0.05)。与治疗前比较,治疗5 d后两组患儿的血小板计数明显升高(P<0.05);观察组患儿治疗5 d后的血小板计数(158.39±12.05)×10^(9)/L高于对照组的(101.67±11.31)×10^(9)/L(P<0.05)。观察组患儿的药物不良反应发生率(1.9%)低于对照组(13.5%)(P<0.05)。结论重症ITP患儿经地塞米松联合不同剂量的丙种球蛋白治疗后,临床症状均能得到改善,且大剂量丙种球蛋白的疗效更佳,患儿血小板计数明显升高,住院时间显著缩短,且安全性更佳,更值得临床推广。Objective To explore the clinical effect of dexamethasone combined with different doses of gamma globulin in the treatment of children with severe immune thrombocytopenic purpura(ITP).Methods A total of 104 children with severe ITP were selected and divided into a control group(52 cases)and an observation group(52 cases)by simple randomization method.The control group was treated with dexamethasone combined with low-dose(400 mg)gamma globulin,and the observation group was treated with dexamethasone combined with high-dose(800 mg)gamma globulin.The clinical efficacy,length of hospital stay,platelet count and incidence of adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation group(98.1%)was higher than that of the control group(86.5%)(P<0.05).The observation group had shorter length of hospital stay of(6.35±0.67)d than(11.23±1.15)d in the control group(P<0.05).Compared with before treatment,the platelet count of the two groups was significantly increased after 5 d of treatment(P<0.05).The observation group had higher platelet count of(158.39±12.05)×10^(9)/L after 5 d of treatment than(101.67±11.31)×10^(9)/L in the control group(P<0.05).The incidence of adverse drug reactions in the observation group(1.9%)was lower than that in the control group(13.5%)(P<0.05).Conclusion The combination of dexamethasone and different doses of gamma globulin can improve clinical symptoms in children with severe ITP;the efficacy of high-dose gamma globulin is better,the children's platelet count increases significantly,and the length of hospital stay is significantly shortened,and the safety of the children is better,which is more worthwhile to be promoted in the clinic.

关 键 词：重症免疫性血小板减少性紫癜 地塞米松 丙种球蛋白 临床疗效 

分 类 号：R725.5[医药卫生—儿科] R969[医药卫生—临床医学]