丙种球蛋白联合地塞米松治疗特发性血小板减少陛紫癜的临床观察

目的旨在观察丙种球蛋白联合地塞米松治疗特发性血小板减少性紫癜的疗效。方法选择2010年1月～2012年12月在我院住院的的50例特发性血小板减少性紫癜患者为研究对象。对符合以上条件的50例患者分为治疗组30例反对照组20例，治疗组中男13例，女17例，平均年龄（43．9±7．5）岁，病程5d～15年；对照组中男8例，女12例，年龄（41．8±7．7）岁，病程7d～12年。对照组予地塞米松40mg／d，静脉输注4d。观察组同时联合应用丙种球蛋白400mg/（kg·d），4d后改强的松1mg/（kg·d）口服，疗程4～6周，比较两组治疗后的疗效及治疗后出血症状控制时间、血小板上升时间、血小板恢复时间。结果观察组治疗后的总有效率与对照组总有效率分别为93.3％、90．0％，组间比较差异不显著（P〉0．05）。观察组显效20例，显效率66．7％．对照组治疗后显效12例，显效率60．0％，两组显效率比较，差异不显著（P〉0．05）。观察组患者治疗后出血症状控制时间（4．1±0．7）d，血小板上升时间（2．1±0．3）d，血小板恢复时间（3．2±0．8）d，上述各指标分别明显短于对照组，差异有显著性（P〈0．05）。结论丙种球蛋白联合地塞米松治疗特发性血小板减少性紫癜疗效确切，可以明显升高血小板，安全性好，值得广泛推广和应用。

Gamma globulin combined with dexamethasone in the treatment of idio- pathic thrombocytopenic purpura

Objective To observe the curative effect of gamma globulin combined with dexamethasone in the treatment of idiopathic thrombocytopenic purpura. Methods From 2010 January to 2012 December,50 cases with idiopathic thromboeytopenic purpura patients as the research object in our hospital.50 patients were in accordance with the above conditions were divided into the treatment group of 30 cases, including 13 cases of male patients, 17 female patients, mean age （43.9±7.5） years old, duration 5 d-15 y; the control group of 20 cases, including 12 cases of male patients, 8 female patients, aged （41.8±7.7） years of age, course of disease 7 d-12 y. The control group were given dexamethasone 40 rag/d, intravenous infusion of 4 days. The observation group and combined application of gamma globulin in 400 mg/ （kg＇d）, 4 days after the prednisone 1 mg/（kg-d） oral, treatment 4 to 6 weeks. Symptom control time, rise time, platelet platelet recovery time of hemorrhage and treatment were compared between the two groups after＇treatment. Results The total efficiency and total effective rate of observation group and the control group after treatment were 93.3%, 90.0%, the difference was not significant between two groups（P〉0.05）. The observation group 20 cases, the effective rate was 66.7%, the control group 12 cases after treatment, markedly effective rate of 60.0%, two group of significant efficiency comparison, the difference was not significant （P 〉 0.05）. Symptom control time （4.1±0.7） days hemorrhage patients in the observation group after treatment, platelet rise time （2.1±0.3） days, platelet recovery time was （3.2±0.8） days, each of the above indexes were significantly shorter than the control group, the difference was significant（P 〈 0.05）. Conclusion Gamma globulin combined with dexamethasone in the treatment of idioPathic thrombocytopenic purpura curative effect, can significantly increase the platelet, security is good, worthy of extensive promotion and application.