ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (5): 438-440.doi: 10.3969/j.issn.1674-3865.2017.05.024

• 临床研究 • 上一篇    下一篇

丙种球蛋白不同剂量治疗小儿免疫性血小板减少症疗效观察

杨海霞，郑敏翠   

  1. 410007 长沙，湖南省儿童医院血液内科
  • 出版日期:2017-10-25 发布日期:2017-12-18
  • 通讯作者: 杨海霞，E-mail：673093648@qq.com
  • 作者简介:杨海霞（1973-），女，医学硕士，副主任医师。研究方向：小儿血液内科疾病的诊治

Clinical comparison of different doses of gamma globulin in the treatment of children with immune thrombocytopenia

YANG Haixia，ZHENG Mincui   

  1. Department of Hematology, Hunan Children 's Hospital, Changsha 410007，China
  • Online:2017-10-25 Published:2017-12-18

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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200 mg/（kg·d）丙种球蛋白治疗，常规剂量组给予400 mg/（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。

关键词: 免疫性血小板减少症, 丙种球蛋白, 儿童

Abstract:
Objective
To observe and analyze the clinical efficacy of different doses of gamma globulin in the treatment of children with immune thrombocytopenia.
Methods
A total of 94 children with immune thrombocytopenia who were treated in our hospital from November 2014 to December 2016 were 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 with 200 mg/(kg·d) gamma globulin. The conventional-dose group was treated with 400 mg/(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.
Results
There 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).
Conclusion
The 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.

Key words: Immune thrombocytopenia, Gamma globulin, Children