48例大剂量地塞米松冲击治疗儿童慢性特发性血小板减少性紫癜的临床疗效观察

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目的通过应用大剂量地塞米松和常规剂量的泼尼松分别治疗儿童慢性特发性血小板减少性紫癜(ITP),探讨大剂量地塞米松冲击治疗儿童慢性ITP的疗效和不良反应。方法回顾性分析邓州市第一人民医院在2010年5月-2012年7月期间收治的48例儿童慢性ITP临床资料,将其随机均分为两组,即试验组(大剂量地塞米松组)和对照组(常规剂量泼尼松组),每组24例患儿,比较两组治疗儿童慢性ITP疗效及不良反应。结果试验组的总反应率为87.5%,对照组75.0%,两组差异无统计学意义(P>0.05);两组随访患者各24例,随访时间均为1年,患儿的长期反应率试验组为58.3%,对照组31.2%,比较两组的长期反应率差异有统计学意义。试验组不良反应发生较少,对照组所有患儿均有不同程度的库欣病的临床表现,4例患儿发生感染。结论大剂量地塞米松冲击治疗儿童慢性ITP不仅长期有效率高,而且不良反应小,并发症少,值得临床推广。 Objective To evaluate the efficacy and adverse reactions of high dose dexamethasone in children with chronic idiopathic thrombocytopenic purpura (ITP) by applying high dose dexamethasone and conventional dose of prednisone. Methods The clinical data of 48 children with chronic ITP admitted to the First People’s Hospital of Dengzhou from May 2010 to July 2012 were retrospectively analyzed. They were randomly divided into two groups, ie, experimental group (high-dose dexamethasone Group) and control group (conventional dose of prednisone group), 24 children in each group. The curative effect and adverse reaction of chronic ITP in children were compared. Results The overall response rate was 87.5% in the experimental group and 75.0% in the control group, with no significant difference between the two groups (P> 0.05). The 24 patients in each group were followed up for 1 year. The long-term response rate The experimental group was 58.3% and the control group was 31.2%. There was significant difference in the long-term response rate between the two groups. Adverse reactions occurred in the experimental group less, all children in the control group have different degrees of clinical manifestations of Cushing’s disease, 4 cases of children infected. Conclusion High-dose dexamethasone shock treatment of children with chronic ITP not only long-term high efficiency, and adverse reactions, fewer complications, worthy of clinical promotion.
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