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目的:探讨不同剂量丙种球蛋白联合地塞米松治疗小儿中重症特发性血小板减少性紫癜(ITP)的疗效。方法:96例ITP患儿随机分为A组(标准大剂量丙种球蛋白+地塞米松)、B组(中剂量丙种球蛋白+地塞米松)和对照组(地塞米松)3组,均连续治疗2周后,比较3组疗效、药品不良反应和治疗前后患儿血小板参数变化情况。结果:A、B两组患儿治疗后Plt、PCT、PDW水平均明显高于对照组(P<0.05),治疗后血小板恢复正常时间和出血停止时间均明显短于对照组(P<0.05),治疗总有效率均明显高于对照组(P<0.05)。A、B两组患儿间治疗后血小板恢复正常时间和出血停止时间,以及治疗总有效率比较,差异均无统计学意义(P>0.05)。三组患儿药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:中剂量丙种球蛋白治疗ITP效果显著,能够达到标准大剂量丙种球蛋白的疗效,且有效减少丙种球蛋白使用剂量,值得临床推广应用。
Objective: To investigate the efficacy of different doses of gamma globulin combined with dexamethasone in the treatment of children with severe idiopathic thrombocytopenic purpura (ITP). Methods: A total of 96 children with ITP were randomly divided into three groups: group A (standard high dose gamma globulin + dexamethasone), group B (medium dose gamma globulin + dexamethasone) and control group (dexamethasone) After two weeks of continuous treatment, three groups of curative effects, adverse drug reactions and changes of platelet parameters in children before and after treatment were compared. Results: After treatment, the levels of Plt, PCT and PDW in both groups A and B were significantly higher than those in the control group (P <0.05). After treatment, the normal time of platelet recovery and the stopping time of bleeding were significantly shorter than those in the control group (P <0.05) , The total effective rate was significantly higher than the control group (P <0.05). A, B between the two groups of children after treatment, platelet recovery time and stop the bleeding time, and the total effective rate, the difference was not statistically significant (P> 0.05). There was no significant difference in the incidence of adverse drug reactions between the three groups of children (P> 0.05). Conclusion: The treatment of ITP with medium dose gammaglobulin is significant, which can achieve the effect of standard large dose gamma globulin and effectively reduce the dosage of gamma globulin, which is worthy of clinical application.