不同剂量丙种球蛋白联合地塞米松治疗儿童特发性血小板减少性紫癜的疗效观察

目的:探讨不同剂量丙种球蛋白联合地塞米松治疗儿童特发性血小板减少性紫癜(ITP)的临床疗效。方法:选择2010年7月至2015年7月间我院收治的特发性血小板减少性紫癜患儿78例,按照随机数字表法将其分为观察组38例及对照组40例。观察组采用200 mg/(kg·d)丙种球蛋白联合地塞米松进行治疗,对照组采用400 mg/(kg·d)丙种球蛋白联合地塞米松进行治疗。对两组患者的临床疗效、治疗前后血小板计数、血小板上升时间、血小板恢复正常时间、出血停止时间、住院时间、不良反应及医疗费用进行观察。结果:两组患儿血小板计数治疗前无显著差异(P0.05),治疗后两组血小板计数均呈逐渐升高趋势(P0.05),但组间比较无统计学差异(P0.05)。两组患儿血小板上升时间、血小板恢复正常时间、出血停止时间及住院时间均接近,无统计学差异(P0.05)。观察组治疗总有效率为94.74%,对照组为95.00%,两组无显著差异(P0.05)。观察组不良反应发生率为8.17%,对照组为12.50%,两者相比无统计学差异(P0.05)。观察组患儿平均医疗费用为(1.25±0.34)万元,对照组患儿平均医疗费用为(2.31±0.40)万元,观察组明显低于对照组,两者差异有统计学意义(P0.05)。结论:不同剂量丙种球蛋白联合地塞米松治疗ITP具有类似的临床疗效及安全性,但小剂量丙种球蛋白组治疗费用明显降低,因此值得临床推广应用。

Clinical Effect of Different Dose Gamma Globulin combined with Dexamethasone in the Treatment of Idiopathic Thrombocytopenic Purpura in Children

Objective:To explore the clinical effect of different dose gamma globulin combined with dexamethasone in the treatment of idiopathic thrombocytopenic purpura (ITP) in children.Methods:78 children with ITP accepted in our hospital from July 2010 to July 2015 were randomly divided into observation group with 38 cases and control group with 40 cases. 200 mg/ (kg·d) gamma globulin combined with dexamethasone was given to observation group, and 400 mg/ (kg·d) gamma globulin combined with dexamethasone was given to control group. Then the clinical efficacy, platelet counts before and after treatment, the time of platelet risen time, platelet and recovery, and the time of stopping bleeding, hospital stays, adverse reactions and medical costs of two groups were observed and compared.Results:Platelet counts before treatment of two groups had no statistically significance (P>0.05), and were raisen during treatment (P<0.05). But the difference between two groups after treatment had no statistically significance (P>0.05). Platelet risen time, platelet recovery time, stop bleeding time and hospital stays of two groups had no difference (P>0.05). Total efficacy of observation group was 94.74%, control group was 95.00 %, there were no statistically difference (P>0.05). The adverse reaction rate of observation group was 8.17 %, of control group was 12.50 %, and there were no statistically difference between two groups (P>0.05). The medical costs of observation group were lower than that of control group, and the difference had statistically significance (P<0.05).Conclusion:Different dose gamma globulin combined with dexamethasone has similar efficacy and safety in the treatment of idiopathic, but using low dose gamma globulin can decrease medical costs, which is worth clinical application.