丙种球蛋白强的松联合治疗急性特发性血小板减少性紫癜近期疗效观察

Therapeutic Effects of Immunoglobulin and Dexmethasone on Children with Acute Idiopathic Thromabocytopenic Purpura

摘要:

目的： 探讨丙种球蛋白、强的松联合治疗血小板减少性紫癜(ITP)的近期疗效。方法： 观察组采用蓉生静丙,剂量每日400mg/kg,连用5d,后续用强的松治疗4周;对照组单用强的松4～6周。 结果： 观察组血小板达高峰时间为1～2周,峰值约180×10 9/L,总有效率为86.7%;对照组上述数值分别为4周,116×10 9/L和40% (P<0.05)。结论： 丙种球蛋白、强的松联合治疗ITP明显优于单用强的松组。

Abstract:

OBJECTIVE: To evaluate the therapeutic effect on children with acute idiopathic thrombocytopenic purpura (AITP) by intravenous immunoglobulin (IVIG) or dexmethasone (DEX). METHODS: Fortysix patients aged from 4 months to 14 years with AITP were randomized to receive IVIG or DEX, and we monitored the platelet count (Tc) and observed the side effects after each treatment. RESULTS: There was no difference in the lasting time of Tc≤20×109/L and the time when Tc increased to ≥50×109/L between the treatment of IVIG and DEX (P>0.05). But the percentage of patients with Tc≥50×109/L was higher in the IVIG group Ⅱ (88%) than in the DEX group (50%) after the 5 day treatment (P<0.05). CONCLUSIONS: We may choose IVIG to treat the patients with AITP complicated by severe mucomenbrane and organ bleeding, while we may use DEX if the patients have no complication.