丙种球蛋白冲击治疗儿童腹型过敏性紫癜疗效观察

Clinical effect of gamma globulin pulse therapy for abdominal Henoch-Schönlein purpura in children

摘要:

目的 探讨大剂量丙种球蛋白冲击治疗腹型过敏性紫癜（HSP）的疗效。方法 33 例腹型HSP患儿随机分为地塞米松组（15 例）和丙种球蛋白组（18 例）。地塞米松组患儿采用地塞米松和常规治疗方法进行治疗；丙种球蛋白组患儿在常规治疗基础上，给予大剂量丙种球蛋白冲击治疗。观察两组患儿临床疗效和复发率。结果 丙种球蛋白组患儿皮疹开始和完全消退时间、腹痛缓解和血便消失时间明显短于地塞米松组（P < 0.05），但呕吐缓解时间及住院时间与地塞米松组差异无统计学意义（P > 0.05）；丙种球蛋白组患儿有效率（95%）明显高于地塞米松组（65%），差异有统计学意义（P < 0.05）；且其6 个月内复发率（5.6%）明显低于对照组（33.3%），P < 0.05。结论 大剂量丙种球蛋白冲击治疗腹型HSP 症状缓解快、有效率高、复发率低。

Abstract:

Objective To study the clinical effect of high-dose gamma globulin pulse therapy for abdominal Henoch-Schönlein purpura (HSP). Methods Thirty-three children with abdominal HSP were randomly assigned to dexamethasone group (15 children) and gamma globulin group (18 children). The children in the dexamethasone group were treated with dexamethasone and conventional treatment, and those in the gamma globulin group were treated with high-dose gamma globulin pulse therapy in addition to the conventional treatment. Clinical outcome and recurrence rate were observed in both groups. Results Compared with the dexamethasone group, the gamma globulin group had a significantly shorter onset time of rash, a significantly shorter time to complete regression of rash, a significantly shorter time to abdominal pain remission, and a significantly shorter time to disappearance of bloody stool, as well as comparable time to vomiting remission and length of hospital stay. The gamma globulin group had a significantly higher response rate than the dexamethasone group (95% vs 65%; P < 0.05) and a significantly lower recurrence rate within 6 months than the dexamethasone group (5.6% vs 33.3%; P < 0.05). Conclusions High-dose gamma globulin pulse therapy has a marked clinical effect in the treatment of abdominal HSP. It is safe and reliable and has a low recurrence rate, and therefore, it holds promise for clinical application.