静注免疫球蛋白及地塞米松治疗特发性血小板减少性紫癜临床观察

探讨大剂量地塞米松（ＤＥＸ）及静注免疫球蛋白（ＩＶＩＧ）治疗特发性血小板减少性紫癜（ＩＴＰ）的疗效及其对血液粘稠度的影响。以ＤＥＸ、ＩＶＩＧ、ＩＶＩＧ加ＤＥＸ治疗ＩＴＰ患儿，观察其血小板数变化，并于治疗前后各抽取静脉血一次。结果显示：１．平均血小板计数升至正常时间：单纯ＤＥＸ治疗组为７天，单纯ＩＶＩＧ组及ＩＶＩＧ加ＤＥＸ组为４天；平均计数峰值：单纯ＩＶＩＧ组及ＩＶＩＧ加ＤＥＸ组高于ＤＥＸ组，但单纯ＩＶＩＧ组与ＩＶＩＧ加ＤＥＸ组之间无显著差异。２．ＩＴＰ患儿治疗后骨髓成熟产板巨核细胞数比例由１．５６±２．５３％升至１３．３６±６．６８％，原幼巨核细胞数比例由４０．２０±１．８７％降至１３．３９±９．２８％，差异非常显著，治疗后各组间骨髓巨核细胞数比例无显著差异。３．ＩＴＰ患儿全血粘度值、血浆粘度值治疗前后三组均无显著变化。结论：ＩＴＰ患儿ＩＶＩＧ治疗较ＤＥＸ治疗血小板上升迅速，上升幅度大。１ＶＩＧ治疗的同时加大剂量ＤＥＸ治疗，未能进一步使血小板升高。

CLINICAL OBSERVATION OF INTRAVENOUS IMMUNOGLOBULINn AND DEXAMETHASONE THERAPY IN PATIENTS WITH IDIOPATHIC THROMBOCYTOPENIC PURPURA.

To realize the clinical effects of high-dose intravenous immunoglobulin (IVIG) and dexamethasone (DEX) therapy in patients with idiopathic thrombocytopenic purpura (ITP) andchanges of their blood viscosity. Platelet counts of peripheral blood were recorded and theblood samples were collected in ITP patients prior to and post treatment Result. showed 1.Time of mean platelet count becoming normal was the seventh day in pure DEX group, andthe forth day in other two groups. 2. After treatment the percentage of mature megakaryocyte was increased, while that of immature megakaryocyte was decreased, but there wereno significant difference among three groups. 3. There were no obviously changes in viscosityof blood in ITP patient after treatment BPC. was increased obviously for IVIG therapy.High-dose DEX treatment wasn' t help for BPC increase in ITP patients while they were beentreated with IVIG.