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大剂量地塞米松治疗小儿免疫性血小板减少症的临床研究
作者:祁海啸  周国平  胡剑  周文娣  洪泽  张荣荣  孙兴珍  王春玲  蒯文霞 
单位:南京医科大学附属淮安第一医院 儿科, 江苏 淮安 223300
关键词:大剂量地塞米松 小儿 免疫性血小板减少症 疗效 
分类号:R720.5;R725.5
出版年·卷·期(页码):2019·38·第二期(255-258)
摘要:

目的:探讨大剂量地塞米松治疗小儿免疫性血小板减少症(ITP)的临床疗效。方法:将60例初诊ITP患儿随机分为治疗组和对照组(各30例),治疗组用大剂量(1 mg·kg-1·d-1)地塞米松静脉滴注,对照组用常规剂量(0.25 mg·kg-1·d-1)地塞米松静脉滴注,比较两组患儿的血小板恢复情况、总有效率及不良反应。结果:治疗组的血小板开始上升时间为(2.95±1.32)d、血小板恢复正常所需时间为(5.86±2.46)d、治疗1周后的血小板数为(152.26±65.73)×109L-1、两周后的血小板数为(212.31±85.26)×109L-1、4周后的血小板数为(181.72±69.68)×109L-1,均优于对照组[对应数值分别为(5.32±2.65)d、(8.53±3.32)d、(85.72±40.68)×109L-1、(163.58±65.82)×109L-1、(116.43±49.75)×109L-1],差异有统计学意义(P<0.05)。治疗组的总有效率(86.67%)高于对照组(63.33%),差异有统计学意义(P<0.05)。治疗组中有1例患儿出现高血压副作用,对照组中未出现副作用,两者差异无统计学意义(P>0.05)。结论:大剂量地塞米松治疗小儿初诊ITP的疗效比常规剂量地塞米松更显著,两者不良反应均轻微,安全性较好。

Objective:To investigate the effectiveness of high-dose dexamethasone on children with immune thrombocytopenia (ITP). Methods:60 cases of newly diagnosed ITP were randomly divided into two groups, the treatment group with high-dose dexamethasone 1 mg·kg-1·d-1 treatment, the control group with routine dose of dexamethasone 0.25 mg·kg-1·d-1 treatment. The platelet recovery, total effective rate and adverse reactions were compared between the two groups. Results:In the treatment group, the time were (2.95±1.32) days when platelet began to rise;the time were (5.86±2.46) days when platelet count returned to normal;the platelet counts were (152.26±65.73)×109L-1 after one week treatment,(212.31±85.26)×109L-1 after two weeks treatment, and (181.72±69.68)×109L-1 after four weeks treatment,which were better than those of the control group[the corresponding values were (5.32±2.65) days, (8.53±3.32) days, (85.72±40.68)×109L-1, (163.58±65.82)×109L-1, (116.43±49.75)×109L-1].The differences were statistically significant (P<0.05).The total effective rate (86.67%) of the treatment group was higher than that of the control group (63.33%) and the difference was statistically significant (P<0.05). One patient occured hypertension as a side effect of hormone in the treatment group while no side effect in the control group, and the difference was not statistically significant (P>0.05). Conclusion:The effectiveness of high-dose dexamethasone in the treatment of children with newly diagnosed ITP is more remarkable than that of conventional dose dexamethasone. Both have slight adverse reactions and good safety.

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