医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2014年
17期
185-186
,共2页
肾上腺皮质激素%小剂量%儿童特发性血小板减少性紫癜
腎上腺皮質激素%小劑量%兒童特髮性血小闆減少性紫癜
신상선피질격소%소제량%인동특발성혈소판감소성자전
adrenocortical hormone%smal dose%ITP
目的：探讨短期小剂量激素治疗对儿童特发性血小板减少性紫癜的临床疗效及安全性。方法：收集我院2009年1月至2013年12月儿童特发性血小板减少性紫癜95例，将其随机分为对照组(43例)及小剂量组(52例)，两组均常规使用IVIG及其他支持疗法，常规组予泼尼松口服，剂量每日2mg/kg，分3次服，血小板水平正常后逐步减量，总疗程不超过4周。小剂量组予泼尼松口服，剂量每日0.25mg/kg，总疗程为3周。统计分析两组在血小板计数上升至50×109/L﹑100×109/L时的治疗时间，停药后3月及6月复发率及两组激素不良反应的发生率。结果：两组患者治疗后血小板上升至50×109/L所需时间无明显差异，t检验分析无统计学差异，P>0.05；而上升至100×109/L小剂量组所需时间更长，经t检验有统计学差异，P<0.05。停药后1月﹑3月小剂量组复发率均比对照组低，但经过卡方检验组间比较均无统计学差异，P>0.05。对照组不良反应较小剂量组高，组间卡方检验有统计学差异，P<0.05。结论：小剂量激素治疗儿童特发性血小板减少性紫癜疗效确切，与传统剂量治疗疗效无差异，且不良反应小，值得在临床广泛推广。
目的：探討短期小劑量激素治療對兒童特髮性血小闆減少性紫癜的臨床療效及安全性。方法：收集我院2009年1月至2013年12月兒童特髮性血小闆減少性紫癜95例，將其隨機分為對照組(43例)及小劑量組(52例)，兩組均常規使用IVIG及其他支持療法，常規組予潑尼鬆口服，劑量每日2mg/kg，分3次服，血小闆水平正常後逐步減量，總療程不超過4週。小劑量組予潑尼鬆口服，劑量每日0.25mg/kg，總療程為3週。統計分析兩組在血小闆計數上升至50×109/L﹑100×109/L時的治療時間，停藥後3月及6月複髮率及兩組激素不良反應的髮生率。結果：兩組患者治療後血小闆上升至50×109/L所需時間無明顯差異，t檢驗分析無統計學差異，P>0.05；而上升至100×109/L小劑量組所需時間更長，經t檢驗有統計學差異，P<0.05。停藥後1月﹑3月小劑量組複髮率均比對照組低，但經過卡方檢驗組間比較均無統計學差異，P>0.05。對照組不良反應較小劑量組高，組間卡方檢驗有統計學差異，P<0.05。結論：小劑量激素治療兒童特髮性血小闆減少性紫癜療效確切，與傳統劑量治療療效無差異，且不良反應小，值得在臨床廣汎推廣。
목적：탐토단기소제량격소치료대인동특발성혈소판감소성자전적림상료효급안전성。방법：수집아원2009년1월지2013년12월인동특발성혈소판감소성자전95례，장기수궤분위대조조(43례)급소제량조(52례)，량조균상규사용IVIG급기타지지요법，상규조여발니송구복，제량매일2mg/kg，분3차복，혈소판수평정상후축보감량，총료정불초과4주。소제량조여발니송구복，제량매일0.25mg/kg，총료정위3주。통계분석량조재혈소판계수상승지50×109/L﹑100×109/L시적치료시간，정약후3월급6월복발솔급량조격소불량반응적발생솔。결과：량조환자치료후혈소판상승지50×109/L소수시간무명현차이，t검험분석무통계학차이，P>0.05；이상승지100×109/L소제량조소수시간경장，경t검험유통계학차이，P<0.05。정약후1월﹑3월소제량조복발솔균비대조조저，단경과잡방검험조간비교균무통계학차이，P>0.05。대조조불량반응교소제량조고，조간잡방검험유통계학차이，P<0.05。결론：소제량격소치료인동특발성혈소판감소성자전료효학절，여전통제량치료료효무차이，차불량반응소，치득재림상엄범추엄。
Objective: To investigate clinical efficacy and safety by short term and smal dose hormone therapy in children with idiopathic thrombocytopenic purpura. Method: Col ection 95 cases with ITP in our hospital from 2009 January to 2013 December, which were randomly divided into control group (43 cases) and smal dose group (52 cases),which were treated using IVIG and other supportive therapy, conventional group were treated with prednisone, 2mg/kg/d, gradual y reduction the dose after platelet to normal level, the total course is not more than 4 weeks. The smal dose group was treated with prednisone, 0.25mg/kg/d, the total course of treatment for 3 weeks. Statistical analysis the treatment time when the platelet count increased to 50×109/L, 100×109/L , and the rate of relapse and adverse reaction after terminate 1 and 3 months. Result:Ther is no significant difference between two groups about platelet increased to 50×109/L, P>0.05; and the time is longer up to 100×109/L in smal dose group,there is significant difference, P<0.05. The recurrence rate of smal dose group was lower than the control group, but there is no significant difference, P>0.05. The control group with less adverse reactions than high dose,there is significant difference, P<0.05. Conclusion: a smal dose of hormone therapy in children with idiopathic thrombocytopenic purpura is effective, and little adverse reaction, is worthy in clinical application.
