双嘧达莫联合小剂量糖皮质激素预防儿童过敏性紫癜肾损害的疗效观察

目的观察双嘧达莫联合小剂量糖皮质激素预防儿童过敏性紫癜(HSP)肾损害的临床疗效。方法将132例HSP患儿随机分为治疗组和对照组,各66例。对照组采用常规疗法,治疗组加用双嘧达莫3～5mg·kg-1·d-1及泼尼松1mg·kg-1·d-1治疗。比较2组患儿紫癜症状消退时间、肾损害发病率、发病时间和肾损害的严重程度(尿红细胞,24h尿蛋白,血、尿β2-微球蛋白的变化情况)。结果治疗组各种临床症状的消退时间明显短于对照组,差异有统计学意义(P<0.05)。2组患儿肾损害的发病率、发病时间及肾损害程度与对照组比较,差异均有统计学意义(P<0.01)。结论双嘧达莫和小剂量糖皮质激素联合应用可有效预防HSP肾损害,改善HSP患者的预后,且无明显不良反应,值得临床推广应用。

The effect of dipyridamole combined with low doses of glucocorticoid to prevent renal damage in children with allergic purpura

Objective To observe the effect of dipyridamole combined with low doses of glucocorticoid to prevent renal damage in children with allergic purpura（HSP）.Methods 132 cases patients of children with HSP were randomly divided into the control group and the treatment group,each of 66 cases.Two groups were treated with the same conventional therapy,while the treatment group were given dipyridamole 3～5mg·kg-1·d-1 and prednisone 1mg·kg-1·d-1.And observed purpura symptoms regression time,the incidence of renal damage,diseasetime and severity of renal damage（the RBC of urine,24-hour urine protein excretion,blood β2-MG and urine β2-MG）.Results Regression time of clinical symptoms of the treatment group were significantly shorter than that of the control group,the difference were statistically significant（P0.05）.Compared the incidence of renal damage,diseasetime and severity of renal damage of two groups,the difference were statistically significant（P0.01）.Conclusion Dipyridamole combined with low-dose glucocorticoid can effective prevent the renal damage of HSP,and improve the prognosis of patients with HSP,no adverse reaction,is worthy of clinical application.