短期小剂量激素治疗儿童特发性血小板减少性紫癜的临床研究.docVIP

精品论文 参考文献 短期小剂量激素治疗儿童特发性血小板减少性紫癜的临床研究 林丽丹 李超雄 　　(江门市中心医院儿内科 广东江门 529030) 　　【摘要】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50times;109/L、100times;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50times;109/L所需时间无明显差异，t检验分析无统计学差异，Pgt;0.05；而上升至100times;109/L小剂量组所需时间更长，经t检验有统计学差异，Plt;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，Pgt;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，Plt;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。 　　【关键词】肾上腺皮质激素 小剂量 儿童特发性血小板减少性紫癜 　　【中图分类号】R969 【文献标识码】A 【文章编号】2095-1752（2014）17-0185-02 　　【Abstract】Objective: To investigate clinical efficacy and safety by short term and small dose hormone therapy in children with idiopathic thrombocytopenic purpura. Method: Collection 95 cases with ITP in our hospital from 2009 January to 2013 December, which were randomly divided into control group (43 cases) and small dose group (52 cases),which were treated using IVIG and other supportive therapy, conventional group were treated with prednisone, 2mg/kg/d, gradually reduction the dose after platelet to normal level, the total course is not more than 4 weeks. The small 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 50times;109/L, 100times;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 50times;109/L, Pgt;0.05; and the time is longer up to 100times;109/L in small dose group,there is significant difference, Plt;0.05. The recurrence rate of small dose group was lower than the control group, but there is no significant difference, Pgt;0.05. The control group with less advers