摘要
目的观察丙种球蛋白不同剂量治疗小儿免疫性血小板减少症的临床疗效。方法 2015年1月至2016年12月湖南省儿童医院血液内科收治住院的免疫性血小板减少症患儿94例,随机分为小剂量组与常规剂量组各47例。两组患儿均给予甲泼尼龙治疗,小剂量组给予200mg/(kg·d)丙种球蛋白治疗,常规剂量组给予400mg/(kg·d)丙种球蛋白治疗,每周1次,治疗1个月。观察两组临床疗效、血小板上升时间、血小板上升至正常时间、血小板达峰值、血小板止血时间、住院时间、治疗费用、白细胞计数、血红蛋白、血小板计数以及不良反应发生情况。结果小剂量组患儿治疗总有效率与常规剂量组比较差异无统计学意义(P>0.05);两组患儿血小板上升时间、血小板上升至正常时间、血小板止血时间、住院时间比较差异无统计学意义(P>0.05);两组患儿治疗后的白细胞计数、血红蛋白对比差异无统计学意义(P>0.05);小剂量组患儿治疗后血小板计数显著高于常规剂量组,血小板达峰值时间显著短于常规剂量组,治疗费用显著少于常规剂量组,差异有统计学意义(P<0.05);两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论不同剂量丙种球蛋白治疗免疫性血小板减少症患儿的临床疗效及安全性相当,但小剂量丙种球蛋白治疗血小板达峰值时间更短,且治疗费用更低,具有临床推广使用价值。
ObjectiveTo observe and analyze the clinical efficacy of different doses of gamma globulin in the treatment of children with immune thrombocytopenia.MethodsA total of94children with immune thrombocytopenia who were treated in our hospital from November2014to December2016were randomly divided into low dose group(n=47)and conventional dose group(n=47).Both groups of children were treated with dexamethasone.The low dose group was treated with200mg/(kg·d)gamma globulin.The conventional dose group was treated with400mg/(kg·d)gamma globulin,once a week for one month.Observe the following items:clinical effect,duration of platelet increase,time of platelet rising to normal level,peak time of platelet,coagulating time of platelet,hospital stay,treatment expense,WBC count,hemoglobin,platelet count and the incidence of adverse reactions.ResultsThere was no statistical difference in the total effective rate between the two groups(P>0.05).There was no statistical difference in duration of platelet increase,time of platelet rising to normal level,coagulating time of platelet or hospital stay(P>0.05)between the two groups.There was no statistical difference in WBC count or hemoglobin(P>0.05)between the two groups(P>0.05).After treatment,the platelet count was significantly higher in low dose group than in conventional dose group and there was statistical difference(P<0.05).The peak time of platelet was significantly shorter in low dose group than in conventional dose group with statistical difference(P<0.05).The treatment expense was also less in the conventional dose group and there was statistical difference(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).ConclusionThe effect and safety of these two doses of gamma globulin is similar in the treatment of children with immune thrombocytopenia;however,the low dose treatment results in shorter peak time of platelet with less expense,so it is worthy of clinical application.
作者
杨海霞
郑敏翠
YANG Haixia;ZHENG Mincui(Department of Hematology, Hunan Children 's Hospital, Changsha 410007,China)
出处
《中国中西医结合儿科学》
2017年第5期70-72,共3页
Chinese Pediatrics of Integrated Traditional and Western Medicine
