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目的探讨70例特发性血小板减少性紫癜(ITP)患儿中2种治疗方案的临床疗效及经济学评价。方法对静脉用丙种球蛋白(IVIG)与地塞米松(GC)静脉联合治疗组及单用GC治疗组进行回顾性分析,并应用成本-效果分析法进行临床经济学评价。采用SPSS 14.0软件进行统计学分析。结果 2组ITP患儿治疗后不良反应、回访情况比较差异均无统计学意义。IVIG+GC组PLT下降极重度[(10～25)×109L-1]、重度(<10×109L-1)、严重出血例数均高于GC组。2组治疗第1-7天PLT上升至正常天数比较,有效率、显效率比较,IVIG+GC组均优于GC组。应用成本-效果法分析GC组相对优于IVIG+GC组。结论对于重度、极重度、出血程度严重的ITP患儿主张选择IVIG+GC治疗;对于轻、中度病例则可选择GC治疗。临床治疗的选择应综合考虑,既要考虑临床疗效,也要兼顾经济因素。
Objective To investigate the clinical efficacy and economic evaluation of two treatment regimens in 70 children with idiopathic thrombocytopenic purpura (ITP). Methods The intravenous administration of IVIG combined with intravenous dexamethasone (GC) and GC alone were retrospectively analyzed and the clinical economic evaluation was conducted by cost-effectiveness analysis. SPSS 14.0 software was used for statistical analysis. Results There were no significant differences in adverse reactions and follow-up between two groups of ITP children after treatment. PLT decreased very significantly in IVIG + GC group [(10 ~ 25) × 109L-1], severe (<10 × 109L-1), severe bleeding were higher than GC group. Compared with GC group, IVIG + GC group was superior in two groups of PLT up to normal days from the first day to the seventh day. The cost-effect method analysis GC group is superior to IVIG + GC group. Conclusions IVIG + GC treatment is recommended for patients with severe, severe and severe bleeding in ITP. GC treatment is recommended for mild and moderate cases. The choice of clinical treatment should be considered, it is necessary to consider the clinical efficacy, but also take into account economic factors.