摘要
目的:探讨中小剂量丙种球蛋白治疗重症特发性血小板减少性紫癜(ITP)患儿的效果。方法:纳入2019年6月-2021年6月龙岩市第一医院收治的120例重症ITP患儿作为观察对象,按随机数字表法分为对照组和观察组,每组60例。对照组给予大剂量静脉用丙种球蛋白(IVIG)治疗,观察组给予中小剂量IVIG治疗。对比两组血小板(PLT)相关指标、免疫功能及PLT复常时间、止血时间、治疗费用、不良反应。结果:治疗后14 d,两组PLT、血小板压积(PCT)、血小板平均体积(MPV)、血小板分布宽度(PDW)水平较治疗前均升高(P<0.05),但两组对比差异均无统计学意义(P>0.05)。治疗后14 d,两组调节性T细胞(Treg)、IgG、IgA、IgM水平较治疗前均增加(P<0.05),但两组对比差异均无统计学意义(P>0.05),辅助性T细胞17(Th17)、Th17/Treg较治疗前均下降(P<0.05),但两组对比差异均无统计学意义(P>0.05)。两组PLT复常时间、止血时间对比,差异均无统计学意义(P>0.05);观察组治疗费用少于对照组(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:中小剂量与大剂量IVIG均能有效改善重症ITP患儿的免疫功能,促进PLT功能数量恢复和出血症状缓解,且不良反应少,但中小剂量IVIG治疗能显著减轻患儿家庭负担。
Objective:To investigate the effect of medium and small dose Gamma Globulin in the treatment of children with severe idiopathic thrombocytopenic purpura(ITP).Method:A total of 120 children with severe ITP treated in Longyan First Hospital from June 2019 to June 2021 were included as the observation objects.They were divided into the control group and the observation group according to the random number table method,60 cases in each group.The control group was treated with high-dose intravenous Immunoglobulin(IVIG),and the observation group was treated with medium and small dose IVIG.Platelet(PLT)related indexes,immune function,PLT normalization time,hemostasis time,treatment cost and adverse reactions were compared between two groups.Result:At 14 day after treatment,the levels of PLT,platelet hematocrit(PCT),mean platelet volume(MPV)and platelet distribution width(PDW)in two groups were higher than those before treatment(P<0.05),but there were no significant differences between two groups(P>0.05).At the 14 day after treatment,the levels of regulatory T cells(Treg),IgG,IgA and IgM in two groups increased compared with those before treatment(P<0.05),but there were no statistical differences between two groups(P>0.05),the helper T cells 17(Th17)and Th17/Treg in two groups decreased compared with those before treatment(P<0.05),but there were no statistical differences between two groups(P>0.05).There were no significant differences in the recovery time of PLT and hemostasis time between two groups(P>0.05).The treatment cost of the observation group was less than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Both medium and small dose IVIG and large dose IVIG can effectively improve the immune function of children with severe ITP,promote the recovery of PLT function and the relief of bleeding symptoms,and has less adverse reactions,however,medium and small dose IVIG can significantly reduce the family burden of children with ITP.
作者
黄圆桃
林钰铭
李红
HUANG Yuantao;LIN Yuming;LI Hong(不详;Longyan First Hospital,Longyan 364000,China)
出处
《中外医学研究》
2022年第23期127-131,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
