大剂量泼尼松口服冲击治疗儿童免疫性血小板减少症的疗效观察

目的探讨大剂量泼尼松口服冲击治疗儿童免疫性血小板减少症(ITP)的临床疗效及安全性。方法选取2011年2月至2013年2月四平市妇婴医院收治的ITP患者300例作为研究对象,采用完全随机设计的方法将患儿分为丙种球蛋白冲击治疗组、甲泼尼龙冲击治疗组和泼尼松口服冲击治疗组,每组各100例。在接受常规治疗的基础上,丙种球蛋白冲击治疗组患者接受丙种球蛋白冲击治疗及泼尼松维持治疗;甲泼尼龙冲击治疗组患者接受甲泼尼龙冲击治疗及泼尼松维持治疗;泼尼松口服冲击治疗组患者接受口服大剂量泼尼松冲击治疗。观察三组患者的治疗效果、血小板计数(PLT)、不良反应情况及花费。结果治疗后三组患儿的疗效比较无统计学意义(H=0.574,P>0.05);治疗第12周及治疗完成后,三组患者的PLT较治疗前显著增高(P<0.05);治疗前、治疗第12周及治疗完成后三组患者PLT比较,差异无统计学意义(F=0.855、0.887、0.802,P>0.05),泼尼松口服冲击治疗组患者的花费及不良反应情况均显著低于丙种球蛋白冲击治疗组和甲泼尼龙冲击治疗组(P<0.05)。结论大剂量口服泼尼松冲击治疗ITP的疗效堪比传统治疗方法,且不良反应较少、费用低,值得临床推广。

Observation on the Efficacy of High-dose Oral Prednisone for Treatment of Immune Thrombocytopenia in Children

Objective To investigate the clinical efficacy and safety of high-dose oral prednisone for treatment of children with immune thrombocytopenia （ITP）. Methods A total of 300 ITP patients from Siping Maternal and Infant Hospital during Feb. 2011 and Feb. 2013 were selected as the research objects, and were divided into gamma globulin treatment group, methylprednisolane pulse therapy group and oral prednisone pulse therapy group by completely randomized design ,each group with 100 cases. Each group was given the conventional treatment, and gamma globulin treatment group received gamma globulin and prednisone maintenance therapy, methylprednisolone pulse therapy group received methylprednisolone pulse therapy and prednisone prednisone maintenance therapy, oral prednisone pulse therapy group was given high-dose oral prednisone. The therapeutic effect, platelet count（ PLT）, adverse reactions and costs were compared. Resuits The efficacy of the three groups after treatment showed no statistical significance （ H = 0. 574, P 〉 0. 05 ）, the PLTafter 12 weeks of treatment completed were significantly higher than before treatment （P 〈 0. 05 ）, but there were no statistically significant difference between the three groups before treatment and 12 weeks after treatment （ F = 0. 855,0. 887,0. 802, P 〉 0.05 ）. The cost and adverse reactions of oral prednisane pulse therapy group were significantly lower than the other two groups （ P 〈 0.05 ）. Conclusion The curative effect of high-dose oral prednisone pulse therapy is comparable to traditional treatment methods, but with feweradverse reactions and lower cost, thus is worthy for promotion in clinical.