丙种球蛋白联合糖皮质激素对小儿原发性免疫性血小板减少性紫癜的疗效及安全性分析  

Efficacy and safety analysis of gamma globulin combined with glucocorticoid in the treatment of primary immune thrombocytopenic purpura in children

作　　者：宫晓丽 王奇坤 GONG Xiao-li;WANG Qi-kun(Department of Pediatrics,Weihai Municipal Second Hospital Affiliated to Qingdao University,Weihai 264200,China)

机构地区：[1]青岛大学附属威海市立第二医院儿科,264200

出　　处：《中国现代药物应用》2024年第14期119-122,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨小儿原发性免疫性血小板减少性紫癜应用丙种球蛋白联合糖皮质激素治疗的效果、安全性。方法选取原发性免疫性血小板减少性紫癜患儿78例,随机分为研究组与对照组,每组39例。对照组患儿单独使用糖皮质激素治疗,研究组则使用丙种球蛋白与糖皮质激素同时治疗。比较两组患儿临床症状缓解时间与治疗时间、血小板指标[血小板体积分布宽度(PDW)、血小板平均体积(MPV)、血小板计数(PLT)]、血清炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]及不良反应发生情况。结果研究组出血缓解时间、血小板恢复时间以及治疗时间均比对照组短(P<0.05)。治疗后,研究组PDW(20.69±3.17)%、MPV(9.25±2.65)fl与对照组的(24.18±3.21)%、(10.73±2.85)fl比较更低,PLT(242.19±20.29)×10^(9)/L与对照组的(199.86±19.82)×10^(9)/L比较更高(P<0.05)。治疗后,研究组hs-CRP(10.18±2.75)mg/L、IL-6(22.29±2.34)pg/ml与TNF-α(26.62±3.95)pg/ml相比于对照组的(13.24±3.02)mg/L、(26.79±4.31)pg/ml、(31.16±4.79)pg/ml更低(P<0.05)。研究组患儿的不良反应发生率与对照组比较没有差异(P>0.05)。结论原发性免疫性血小板减少性紫癜患儿临床治疗过程中应用丙种球蛋白联合糖皮质激素具有更加明显的疗效,可促使其血小板和炎症情况有效改善,具有较高的安全性。Objective To explore the effect and safety of gamma globulin combined with glucocorticoid in the treatment of primary immune thrombocytopenic purpura in children.Methods 78 children with primary immune thrombocytopenic purpura were randomly divided into a study group and a control group,with 39 cases in each group.The control group was treated with glucocorticoids alone,while the study group was treated with gamma globulin and glucocorticoids simultaneously.Both groups were compared in terms of clinical symptom remission time and treatment time,platelet indicators[platelet distribution width(PDW),mean platelet volume(MPV),platelet count(PLT)],serum inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],and occurrence of adverse reactions.Results The bleeding remission time,platelet recovery time and treatment time of the study group were shorter than those of the control group(P<0.05).After treatment,the study group had PDW of(20.69±3.17)%and MPV of(9.25±2.65)fl,which were lower than(24.18±3.21)%and(10.73±2.85)fl of the control group;PLT of the study group was(242.19±20.29)×10^(9)/L,which was higher than(199.86±19.82)×10^(9)/L of the control group(P<0.05).After treatment,the study group had hs-CRP of(10.18±2.75)mg/L,IL-6 of(22.29±2.34)pg/ml and TNF-αof(26.62±3.95)pg/m,which were lower than(13.24±3.02)mg/L,(26.79±4.31)pg/ml and(31.16±4.79)pg/ml of the control group(P<0.05).There was no difference in the incidence of adverse reactions between the study group and the control group(P>0.05).Conclusion In the clinical treatment of children with primary immune thrombocytopenic purpura,the application of gamma globulin combined with glucocorticoid has a more obvious effect,which can effectively improve their platelets and inflammation,and has a high safety.

关 键 词：丙种球蛋白 糖皮质激素 小儿 原发性免疫性血小板减少性紫癜 免疫功能 

分 类 号：R725.5[医药卫生—儿科]