摘要
目的探讨血浆置换术联合西米替丁治疗过敏性紫癜的疗效及对血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、免疫球蛋白(Ig)水平的影响。方法选取2016年1月至2017年12月就诊的过敏性紫癜患儿50例,随机分为西米替丁组和联合治疗组,各25例。两组均使用西米替丁注射液进行治疗,每日10 mg/kg静脉滴注,共14 d;联合治疗组在此基础上进行血浆置换,隔日1次,5次为1个疗程。采集两组患者治疗前及治疗14 d后血清样本,酶联免疫吸附实验法检测血清TNF-α、IL-6含量,免疫透射比浊法检测血清IgA、IgM、IgG和IgE含量,对两组临床症状消退时间、治疗效果及不良反应发生情况进行对比。结果治疗后两组血清TNF-α、IL-6含量明显低于治疗前,且联合治疗组低于西米替丁组(P均<0.01)。(2)治疗后,两组IgA、IgM及IgE含量显著低于治疗前,且联合治疗组低于西米替丁组(P均<0.01);两组IgG含量明显高于治疗前,且联合治疗组明显高于西米替丁组(P均<0.01)。(3)联合治疗组皮疹、腹痛、消化道症状、紫癜等临床症状体征消失时间明显短于西米替丁组(P均<0.01);联合治疗组治疗总有效率较西米替丁组有增高趋势,不良反应发生率较西米替丁组有降低趋势,但差异无统计学意义(P均>0.05)。结论血浆置换术联合西米替丁治疗过敏性紫癜可以有效降低患儿血清炎症因子,缩短临床症状体征消失时间。能否在总有效率和不良反应发生率方面获得有统计学意义的改善,有待进一步研究。
Objective To investigate the effect of plasmapheresis combined with cimetidine in the treatment of allergic purpura and its influence on serum levels of tumor necrosis factor ( TNF)-α, interleukin (IL)-6 and immunoglobulin. Methods Fifty children with allergic purpura treated from January 2016 to December 2017 were divided into cimetidine group and combined treatment group randomly ( n = 25, each). Both groups were treated with cimetidine injection (intravenous drip of 10 mg/kg per day for 14 days), and the combined treatment group was additionally given plasmapheresis (5 times as a course of treatment). Enzyme-linked immunosorbent assay ( ELISA) was used to detect the levels of serum TNF-α and IL-6, and immunoturbidimetry was used to detect the levels of serum immunoglobulin( Ig). The clinical symptoms, therapeutic effects and adverse reactions of the two groups were compared. Results The serum levels of TNF-α and IL-6 were lower after the treatment in both groups, and they were significantly lower in the combined treatment group than those in the cimetidine group (all P <0. 01 ). After treatment, the contents of IgA, IgM and IgE were lower after the treatment in both groups, and they were significantly lower in the combined treatment group than those in the cimetidine group (all P <0. 01 ). After the treatment, the contents of IgG were significantly higher in both groups, and it was higher in combined treatment group than that in the cimetidine group ( all P <0. 01). The disappearance time of clinical symptoms in the combined treatment group was significantly shorter than that in the cimetidine group ( all P <0. 01 ). The total effective rate of the combined treatment group was slightly higher than that of the cimetidine group, and the incidence of adverse reactions was slightly lower than that of the cimetidine group, but there were no significant differences ( all P > 0. 05 ). Conclusions Plasmapheresis combined with cimetidine in the treatment of anaphylactoid purpura can effectively reduce the levels of serum inflammatory factors and shorten the disappearance time of clinical symptoms. Whether the total effective rate and adverse reactions can be improved in a statistically significant way remains to be further studied.
作者
周文杰
金民
徐蕾
ZHOU Wen-jie;JIN Min;XU Lei(Department of Blood Transfusion, The Second People's Hospital of Huai' an, Huai'an, Jiangsu 223001 , China)
出处
《中国临床研究》
CAS
2019年第7期954-957,共4页
Chinese Journal of Clinical Research
