抗病毒干预治疗复发性儿童特发性血小板减少性紫癜

目的探讨阿昔洛韦＋喜炎平抗病毒结合静脉免疫球蛋白（IVIG）、长春新碱（VCR）、地塞米松（DEX）干预治疗对复发性儿童特发性血小板减少性紫癜（ITP）防治效果。方法40例伴DNA病毒感染的复发ITP患儿随机分为两组,20例采用阿昔洛韦（（10～15 mg）（/kg.d）静点7～10 d）＋喜炎平（（2.5～5 mg）（/kg.d）静点7～10 d）抗病毒干预治疗结合IVIG（1g/kg.d静点1～2 d）＋VCR（1.5mg/m2.d静点8 h以上,每周1次,共4～6次）＋DEX（15mg（/m2.d）即0.5 mg（/kg.d）静点3 d后口服醋酸泼尼松（60mg/（m2.d）即2 mg（/kg.d）分3次,共14～21 d）常规冲击治疗并与20例常规组比较防治效果。结果治疗7 d时两组血小板计数均达正常范围;治疗21 d时两组血小板计数有所降低,干预组（146.35±48.38×10^9/L）高于常规组（123.41±26.48×10^9/L）有显著差异（P〈0.05）;治疗2个月时两组血小板计数有所升高,干预组（184.53±86.74×109/L）高于常规组（134.58±75.26×10^9/L）有显著差异（P〈0.05）。两组病例在治疗后达显效例数虽然干预组（19/20）较高,达进步例数干预组（1/20）较低,但均无显著差异（P〉0.05）。两组病例在治疗后随访1年,发现干预组复发例数（8/20）较常规组（15/20）少,具有显著差异（P〈0.05）。结论抗病毒干预疗法对复发ITP预防和治疗危险性出血与常规组相当,较常规组更能稳定病情并减少复发。

Effects of compositive treatment with anti-virus therapy on recurrent childhood idiopathic thrombocy-topenic purpura

Objective To explore the effects of compositive treatment combing Acyclovir and Xiyanping with immunoglobulin （IG）,Vincrisul （VCR） and dexamethasone （DEX） on recurrent childhood idiopathic thrombocy- topenic purpura（ITP）. Methods 40 cases of recurrent childhood ITP were divided to two groups at random. The effects of compositive treatment combing Acyclovir （15mg/（kg＇d）,intravenous infusion for 7-10d ays）and Xiyan-ping（（0.1-0.2）mL/（kg·d）,intravenous infusion for 7-10d ays） with IG（lg/（kg·d） ,intravenous infusion for 1-2d ays）, VCR （1.5mg/（m2·d）,intravenous infusion for 8 consecutive hours every week in totall 4-6 times）and DEX （15mg/（m2·d） ,intravenous infusion for 3 days,and then Prednisone （60mg/（m2·d）） taken by mouth for 14-21 days,normal therapy） on 20 cases recurrent childhood ITP（interfere group） were observed as well as those of norreal therapy on 40 others patients. Results The PLT of two groups achieved normal,on day 7,on day 21 ,the PLT of two groups were dropped slowly,but,those （146.35±48.38×10^9/L） of interfere group were higher significantly than those （123.41±26.48×10^9/L）of normal group （P〈0.05）. On month 2,the PLT of two groups were effectively increased,and those （184.53±86.74×10^9/L）of interfere group were also higher than those （134.58±75.26×10^9/L）of normal group （P〈0.05）. After treatment,there was no significant difference between interfere group（ 18/20, 1/20） and normal group （17/20,3/20） than those of normal groupcomparing cases of noticeable effect or further effect （P〉0.05）. Return visitation for one year,there was significant difference in the cases of recurrent ITP between interfere group （8/20） and normal groups （15/20）（P〈0.05）. Conclusion The anti-virus interfere theray has same prevention function, treatment to dangerous blood as the normal theray, but, that could lower the recurrent rate.