丙氨酰-谷氨酰胺营养支持联合甲基泼尼松龙治疗儿童腹型过敏性紫癜的临床观察  

Clinical observation of alanyl-glutamine nutritional support combined with methylprednisolone in the treatment of children with abdominal anaphylactoid purpura

作　　者：王丽娟[1] 孙林军 肖冬菊 WANG Li-Juan;SUN Lin-Jun;XIAO Dong-Ju(Department of Pediatric Intensive Care Medicine,Changsha Central Hospital Affiliated to Nanhua University,Changsha 410004,Hunan,China)

机构地区：[1]南华大学附属长沙中心医院儿童重症医学科,湖南长沙410004 [2]湖南科技职业学院药学院

出　　处：《吉林医学》2024年第10期2453-2456,共4页Jilin Medical Journal

基　　金：湖南省自然科学基金项目[项目编号:2022JJ4414]。

摘　　要：目的:观察丙氨酰-谷氨酰胺营养支持联合甲基泼尼松龙治疗儿童腹型过敏性紫癜的临床效果。方法:回顾性选取2021年2月~2024年1月南华大学附属长沙中心医院收治的腹型过敏性紫癜患儿60例,分为对照组和营养组,对照组患儿28例,采用甲基泼尼松龙治疗,营养组患儿32例,在对照组基础上联合丙氨酰-谷氨酰胺营养支持。比较两组患儿住院时间、症状反复、体重下降情况等临床效果、腹痛缓解时间、治疗前后免疫功能变化、出现感染、腹泻、失眠、消化道出血等不良反应情况。结果:相比于对照组,营养组患儿住院时间更短,出现症状反复及体重下降比例更低,差异有统计学意义(P<0.05);营养组患儿腹痛缓解时间≤1 d的比例更高,>1 d的比例均更低,差异有统计学意义(P<0.05);营养组患儿治疗后免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平均更低,差异有统计学意义(P<0.05);营养组患儿不良反应发生率更低,差异有统计学意义(P<0.05)。结论:丙氨酰-谷氨酰胺营养支持联合甲基泼尼松龙治疗儿童腹型过敏性紫癜能够缩短患儿住院时间、减少症状反复及体重下降的情况,缓解患儿早期腹痛,降低不良反应发生率,对患儿更加安全。Objective To observe the clinical effect of alanyl-glutamine nutritional support combined with methylprednisolone in the treatment of children with abdominal anaphylactoid purpura.Method Sixty children with abdominal anaphylactoid purpura admitted to our hospital from February 2021 to January 2024 were retrospectively selected and divided into control group and nutritional group.28 children in the control group were treated with methylprednisolone,and 32 children in the nutritional group were treated with alanylglutamine nutritional support on the basis of the control group.The clinical effects of hospital stay,repeated symptoms,weight loss,abdominal pain relief time,changes in immune function before and after treatment,infection,elevated blood pressure,insomnia,gastrointestinal bleeding and other adverse reactions were compared between the two groups.Results Compared with the control group,the hospital stay in nutrition group was shorter,the proportion of recurrent symptoms and weight loss was lower(P<0.05).The proportion of abdominal pain relief time≤1 day was higher in nutrition group,and the proportion of abdominal pain relief time>1 day was lower(P<0.05).The levels of Immunoglobulin A(IgA),Immunoglobulin G(IgG)and Immunoglobulin M(IgM)in the nutritional group were lower after treatment(P<0.05).The incidence of adverse reactions was lower in nutrition group(P<0.05).Conclusion Alanylglutamine nutritional support combined with methylprednisolone in the treatment of children with abdominal anaphylactoid purpura can shorten the hospital stay of children,reduce the recurrence of symptoms and weight loss,alleviate early abdominal pain in children,reduce the incidence of adverse reactions,and be safer for children.

关 键 词：丙氨酰-谷氨酰胺 甲基泼尼松龙 营养支持 腹型过敏性紫癜 

分 类 号：R554.6[医药卫生—血液循环系统疾病]