摘要
目的 研究甲泼尼龙冲击递减疗法治疗重型腹型过敏性紫癜( H S P)的临床效果。方法 选择铁岭市中心医院2016年1月-2019年1月收治的小儿重症腹型H SP患儿92例,随机分为观察组和对照组各46例。两组均在常规治疗方案基础上接受激素治疗,对照组采用大剂量甲泼尼龙冲击治疗后口服泼尼松;而观察组采用大剂量甲泼尼龙冲击治疗后递减减量,之后改为口服泼尼松,比较两组患儿的症状、免疫指标改善情况和不良反应发生率。结果 观察组皮疹消退时间、腹痛缓解时间、便潜血转阴时间、关节痛消失时间和肾功能恢复时间均短于对照组,差异均有统计学意义( P<0.05)。两组治疗后IgG呈上升趋势,与治疗前相比差异有统计学意义( P<0.05),而组间差异无统计学意义(P>0.05);IgA、C3、IL-6、IL-8、TNF-α呈下降趋势,与治疗前相比差异有统计学意义(P<0.05),组间差异有统计学意义(P<0.05)。对照组不良反应发生率为8.70%;观察组不良反应发生率为13.04%,差异无统计学意义(P>0.05)。结论 甲泼尼龙冲击递减疗法治疗重型腹型HSP能够快速缓解临床症状和免疫状态,并且未明显增加不良反应,值得临床推广应用。
Objective To study the clinical effect of methylprednisolone pulse therapy on severe abdominal allergic purpura (HSP). Methods A total of 92 children with severe abdominal HSP admitted to our hospital from January 2016 to January 2019 were randomly divided into observation group and control group, with 46 cases in each group. Both groups received hormone therapy on the basis of routine treatment, while the control group received prednisone orally after high-dose methylprednisolone pulse therapy, while the observation group received a decreasing dose of methylprednisolone pulse therapy, and then changed to prednisone orally. The symptoms, immune index improvement and adverse reaction rates of the two groups were compared. Results The time of rash subsidence, abdominal pain relief, occult blood turning negative, joint pain disappearance and renal function recovery in the observation group were significantly shorter than those in the control group (P<0.05). After treatment, IgG in the two groups showed an significant upward trendencycompared with pre-treatment (P<0.05), but there was no significant difference between the two groups (P>0.05). IgA, C3, IL-6, IL-8, and TNF-alpha after post-treatment showed a significantly downward trendencycompared with pre-treatment (P<0.05), and there was significant difference between observation group and control group (P<0.05). The incidence of adverse reactions was 8.70% in the control group and 13.04% in the observation group, with no significant difference (P>0.05). Conclusion Methylprednisolone pulse therapy for severe abdominal HSP can quickly relieve clinical symptoms and immune status, and has no significant increase in adverse reactions, which is worthy of clinical application.
作者
项璐
XIANG Lu(Pharmacy Department of Tieling Central Hospital, Tieling 112001, Liaoning Province, China)
出处
《中国实用乡村医生杂志》
2019年第10期68-71,共4页
Chinese Practical Journal of Rural Doctor
关键词
过敏性紫癜
重症
腹型
小儿
甲泼尼龙
冲击递减疗法
Henoch-Schonlein Purpura
Severe
Abdominal Type
Children
Methylprednisolone
Shock Decreasing Therapy
