ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2018, Vol. 10 ›› Issue (5): 436-439.doi: 10.3969/j.issn.1674-3865.2018.05.020

• 临床研究 • 上一篇    下一篇

丙种球蛋白联合甲泼尼龙冲击治疗对免疫性血小板减少症患儿的临床效果和安全性分析

何姗,吴攀   

  1. 410007 长沙，湖南省儿童医院血液内科
  • 出版日期:2018-10-25 发布日期:2018-12-03
  • 通讯作者: 何姗，E-mail：tyyan_kl@163.com
  • 作者简介:何姗(1987-)，女，医学硕士，医师。研究方向：儿童血液肿瘤疾病的诊治

Clinical efficacy and safety of intravenous gamma globulin combined with methylprednisolone pulse therapy for children with immune thrombocytopenia

HE Shan, WU Pan   

  1. Department of Hematology, Hunan Children's Hospital, Changsha 410007，China
  • Online:2018-10-25 Published:2018-12-03

PDF (PC)

116

摘要：
目的
探讨丙种球蛋白联合甲泼尼龙冲击治疗免疫性血小板减少症的疗效。
方法
选取2016年8月至2017年12月湖南省儿童医院收治的免疫性血小板减少症患儿106例为研究对象，随机分为观察组和对照组各53例。对照组患儿实施甲泼尼龙冲击治疗，观察组患儿采用静脉滴注丙种球蛋白联合甲泼尼龙治疗。观察两组患儿在治疗3周后的临床疗效，对比两组血小板计数、血红蛋白、白细胞计数、血小板恢复时间、出血停止时间，观察随访6个月后的复发率和治疗期间不良反应发生率，包括柯兴综合征面容、头痛、恶心等。
结果
观察组总有效率为94.34%(50/53)，显著高于对照组73.58%(39/53)，差异有统计学意义(P<0.05)。治疗后观察组患儿血小板计数显著高于对照组，差异有统计学意义(P<0.05)，观察组患儿血小板恢复时间、出血停止时间显著低于对照组，差异有统计学意义(P<0.05)；观察组患儿血红蛋白和白细胞计数显著低于对照组，差异有统计学意义(P<0.05)。观察组患儿随访6个月复发率为5.66%(3/53)，显著低于对照组18.86%(10/53)，差异有统计学意义(P<0.05)。两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。
结论
对免疫性血小板减少症患儿实施静脉用丙种球蛋白联合甲泼尼龙冲击治疗后，能取得显著效果，有助于改善患儿病情，具有推广应用的积极意义。

关键词: 免疫性血小板减少症, 丙种球蛋白, 甲泼尼龙冲击, 儿童

Abstract:
Objective
To investigate the efficacy of gamma globulin combined with methylprednisolone in the treatment of immune thrombocytopenia.
Methods
Totally 106 children with immune thrombocytopenia admitted to Hunan Children's Hospital from August 2016 to December 2017 were randomly divided into observation group and control group, with 53 cases in each group. The control group was treated with methylprednisolone pulse therapy, while the observation group was treated with intravenous gamma globulin combined with methylprednisolone. The clinical effects of the two groups were observed after 3 weeks of treatment. The platelet count, hemoglobin, white blood cell count, platelet recovery time and hemorrhage stopping time were compared between the two groups. The recurrence rate after 6 months of follow-up and the incidence of adverse reactions during the treatment were observed, including Coxin syndrome, headache, nausea and so on.
Results
The total effective rate of observation group was 94.34%(50/53), which was significantly higher than that of control group(73.58%,39/53), and the difference was statistically significant(P<0.05). After treatment, the platelet count of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P<0.05).The platelet recovery time and hemorrhage stopping time of observation group were significantly shorter than those of control group(P<0.05).The hemoglobin and white blood cell count were significantly lower in the observation group than in the control group(P<0.05). The recurrence rate of the observation group was 5.66%(3/53) after 6 months of followup, which was significantly lower than that of the control group(18.86%,10/53), and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).
ConclusionIntravenous gamma globulin combined with methylprednisolone pulse therapy for children with immune thrombocytopenia can achieve significant effects, which helps to improve the condition of children and is worth popularization and application.

Key words: Gamma globulin, Methylprednisolone shock, Immune thrombocytopenia, Children