摘要
目的:评价大剂量单剂免疫球蛋白联合地塞米松、常规剂量免疫球蛋白及地塞米松两种方法治疗儿童急性型重症特发性血小板减少性紫癜(ITP)的疗效。方法:将血小板<20×109/L,伴明显皮肤黏膜出血的36例重症ITP随机分成两组(A组、B组),每组18例。大剂量冲击治疗组(A组)静脉滴注免疫球蛋白1g.kg-1.d-1,应用1d;静脉滴注地塞米松1mg·kg-1.d-1,连用3d,第4天减量0.5mg·kg-1.d-1,连用2d。常规剂量治疗组(B组)静脉滴注免疫球蛋白0.4g.kg-1.d-1,连用5d;静脉滴注地塞米松0.4 mg·kg-1.d-1,连用5d。两组均于第6天改为口服强的松1mg·kg-1.d-1。结果:A、B两组治疗后血小板上升至安全线30×109/L以上分别是(1.2±0.3)、(2.3±0.4)d;血小板上升至50×109/L以上分别是(2.1±0.4)、(3.2±0.5)d;血小板上升至100×109/L以上分别是(4.2±0.6)、(6.5±1.1)d;组间差异有统计学意义(P<0.05)。结论:大剂量单剂免疫球蛋白联合地塞米松冲击治疗重症ITP血小板上升更快,效果更好,费用较低,宜推广。
Objective： To evaluate the effect of high-dose intravenous immunoglobulin （HDIVIG） and dexamethasone on treating acute and severe idiopathic thrombocytopenic purpura （ITP） of children. Methods： 36 severe ITP children whose blood platelet were less than 20 × 10^9/L and with obvious mucocutaneous hemorrhage were randomly divided into Group A and B with 18 cases in each group. Patients in Group A were treated with mg·kg^-1.d^-1 HDIVIG for 1 day; 1 mg·kg^-1.d^-1 dexamethasone for 3 successive days,and the dose was reduced to 0.5 mg·kg^-1.d^-1 until the 4^th day for 2 successive days. Patients in the conventional dose treatment group （Group B） were treated with 0.4 g ·kg^-1·d^-1HDIVIG and 0.4 mg·kg^-1.d^-1dexamethasone for 5 successive days. Patients in both groups changed to take 1 mg·kg^-1.d^-1 oral prednisone from the 6＇h day. Results： After the treatment,the time of the number of blood platelet of Group A and B reached above the safety line of 30×10^9/L was at the （1.2±0.3） and （2.3±0.4） days,50× 10^9/L at the （2.1＋0.4） and （3.2±0.5） days,and IOOXIOg/L at the （4.2-{-0. 6） and （6.5±1.1） days respectively,which were of statistical difference between the two groups （P^0.05）. Conclusion. The combined appli- cation of HDIVIG and dexamethasone to treating severe ITP has the advantages of increasing the blood platelet more quickly,better effect and lower cost,which is worth popularizing.
出处
《华夏医学》
CAS
2012年第2期154-157,共4页
Acta Medicinae Sinica
