CAJ | 학술논문

目的探讨甲基强的松龙联合丙种球蛋白冲击治疗过敏性紫癜重症患儿的临床疗效.方法 53例过敏性紫癜重症患儿随机分为2组.治疗组21例,采用甲基强的松龙15～30 mg/(kg·d),加入5%葡萄糖150～200 mL静脉点滴(1 h内滴完),连续应用3 d后改用琥珀酸氢化可的松10 mg/(kg·d),加入5%葡萄糖150～250 mL静脉点滴,连续应用10 d,再予强的松1 mg/(kg·d)晨顿服,逐渐减量至停用,疗程4周;甲基强的松龙冲击治疗的同时给予静脉用丙种球蛋白400 mg/(kg·d)静脉点滴,疗程3～5 d.对照组32例,给予琥珀酸氢化可的松10 mg/(kg·d),加入5%葡萄糖150～250 mL静脉点滴,连续应用14 d,再予强的松1 mg/(kg·d)晨顿服,逐渐减量至停用,疗程4周.观察2组皮疹、腹痛、消化道症状及关节症状消退时间.结果治疗组皮疹、腹痛、消化道症状及关节症状消退时间明显短于对照组(P＜0.01或P＜0.05),且治疗组住院天数较对照组明显缩短(P＜0.01).结论甲基强的松龙联合丙种球蛋白冲击治疗过敏性紫癜重症患儿疗效显著,为临床治疗过敏性紫癜重症者提供了一个很好的选择.
목적 탐토갑기강적송룡연합병충구단백충격치료과민성자전중증환인적림상료효.방법 53례과민성자전중증환인수궤분위2조.치료조21례,채용갑기강적송룡15～30 mg/(kg·d),가입5%포도당150～200 mL정맥점적(1 h내적완),련속응용3 d후개용호박산경화가적송10 mg/(kg·d),가입5%포도당150～250 mL정맥점적,련속응용10 d,재여강적송1 mg/(kg·d)신돈복,축점감량지정용,료정4주;갑기강적송룡충격치료적동시급여정맥용병충구단백400 mg/(kg·d)정맥점적,료정3～5 d.대조조32례,급여호박산경화가적송10 mg/(kg·d),가입5%포도당150～250 mL정맥점적,련속응용14 d,재여강적송1 mg/(kg·d)신돈복,축점감량지정용,료정4주.관찰2조피진、복통、소화도증상급관절증상소퇴시간.결과 치료조피진、복통、소화도증상급관절증상소퇴시간명현단우대조조(P＜0.01혹P＜0.05),차치료조주원천수교대조조명현축단(P＜0.01).결론 갑기강적송룡연합병충구단백충격치료과민성자전중증환인료효현저,위림상치료과민성자전중증자제공료일개흔호적선택.
Objective To explore the efficacy of pulse therapy with methylprednisolone combined with intravenous immunoglobulin for child patients with severe Henoch-Schonlein purpura.Methods Fifty-three child patients with severe Henoch-Schonlein purpura were randomly divided into treated group (21 patients) and controlled group (32 patients).Patients in treated group received methylprednisolone[15～30 mg/(kg·d))+5%GS 150～200 mL(i.v.gtt.,1 h)] for three days followed by hydrocortisone sodium succinate[10 mg/(kg·d)+5%GS150～250 mL(i.v.gtt.)] for ten days,and then oral prednisone 1 mg/(kg·d) was followed and gradually reduced dose to stop,the total course of treatment was for 4 weeks;In the meantime,intravenous immunoglobulin [400 mg/(kg·d),i.v.gtt.] was given for 3～5 days.While patients in controlled group were assigned to hydrocortis-one sodium succinat [10 mg/(kg·d)+5%GS 150～250 mL(i.v.gtt.)] for fourteen days followed by oral prednisone [1 mg/(kg·d)] and gradually reduce dose to stop,the total course of treatment was for 4 weeks.T test was used to compare the disappearing time of tetter,bellyache,symptom of alimentary tract and joint in these two groups.Results The disappearing time of tetter,bellyache,symptom of alimentary tract and joint was significantly shorter in treated group than that in controlled group (P＜0.01 or P＜0.05),as well as the time of hospitalization in treated group was also significantly shorter than that in controlled group (P＜0.01).Conclusion Pulse therapy with methylprednisolone combined with intravenous immunoglobulin appears to be an effective treatment for child patients with severe Henoch-Schonlein purpura.