李海燕

【摘要】 目的：分析不同治療方案对小儿急性免疫性血小板减少性紫癜（ITP）的疗效，寻求急性ITP安全有效的治疗方法。方法：选取2010年2月-2015年10月就诊于本院的小儿急性ITP患者98例，依据治疗方式的不同将研究对象分为A组（n=31）、B组（n=33）、C组（n=34）。A组在压迫止血等治疗的基础上联合注射用甲泼尼龙琥珀酸钠治疗，B、C组在A组基础上分别经静脉滴注1、2 g/kg人免疫球蛋白，均连续治疗7 d，比较三组治疗前后的血小板计数及临床疗效。结果：治疗第4天、治疗后，三组血小板计数均高于治疗前，B、C组均高于A组，差异均有统计学意义（P<0.05），但B、C组血小板计数比较，差异均无统计学意义（P>0.05），且治疗后三组血小板计数均高于治疗第4天（P<0.05）;治疗第4天、治疗后，B、C组总有效率均高于A组（P<0.05），但B、C组总有效率比较，差异无统计学意义（P>0.05）;患者治疗期间肝肾功能正常，均未见有严重并发症发生。结论：注射用甲泼尼龙琥珀酸钠联合人免疫球蛋白是小儿急性ITP安全有效的治疗方式，可考虑推广运用。

【关键词】 免疫性血小板减少性紫癜; 治疗方案; 疗效; 血小板计数

【Abstract】 Objective：To analyze the therapeutic effect of different therapeutic schemes on acute immune thrombocytopenic purpura（ITP）in children，and to find a safe and effective method for the treatment of acute ITP.Method：A total of 98 children with acute ITP treated in our hospital from February 2010 to October 2015 were selected.According to the different treatment methods，they were divided into A group（n=31），B group（n=33）and C group（n=34）.A group was treated with Methylprednisolone Sodium Succinate for Injection on the basis of oppressive hemostasis，on the basis of A group，B group and C group received intravenous drip of Human Immunoglobulin 1 g/kg and 2 g/kg respectively，they were treated continuously for 7 days.The platelet count and clinical efficacy of three groups before and after treatment were compared.Result：On the 4th day and after treatment，the platelet counts in three groups were higher than those of before treatment，and those in B and C groups were higher than those of A group，the differences were statistically significant（P<0.05），but the platelet counts in B and C groups were compared，the differences were not statistically significant（P>0.05），and the platelet count in three groups after treatment were higher than those of the 4th day of treatment（P<0.05）.On the 4th day and after treatment，the total effective rate of B and C groups were higher than those of A group（P<0.05），but the total effective rate of B and C groups was compared，the differences were not statistically significant（P>0.05）.During the treatment，the liver and kidney functions were normal，and no serious complications occurred.Conclusion：Methylprednisolone Sodium Succinate for Injection combined with Human Immunoglobulin is a safe and effective treatment for acute ITP in children，which can be considered to be popularized.

【Key words】 Immune thrombocytopenic purpura; Therapeutic schemes; Therapeutic effect; Platelet count

First-authors address：The Peoples Hospital of Macheng，Macheng 438300，China

doi：10.3969/j.issn.1674-4985.2019.16.008

急性免疫性血小板减少性紫癜（Immune thrombocytopenic purpura，ITP）属小儿（≤14岁）较为常见的出血性疾病，其引发的颅内出血有显著的致死特性，已引起小儿领域同仁的广泛关注[1-3]。目前，大剂量人免疫球蛋白和糖皮质激素冲击疗法仍是急性ITP治疗的一线选择[4-5]。本研究分析不同治疗方案对小儿ITP的疗效，寻求急性ITP安全有效经济的治疗方法，现报道如下。

1 资料与方法

1.1 一般资料 选取2010年2月-2015年10月就诊于本院的小儿急性ITP患者98例，其中男44例，女54例;年龄10个月～11岁，平均（5.34±2.18）岁。（1）诊断标准参照张之南等[6]制定的标准，满足①②③④项及⑤中任何一项即可确诊：①2次及……