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目的:探讨儿童过敏性紫癜凝血状态以及早期抗凝治疗对患儿的临床意义,为临床治疗提供参考。方法:选择2011年1月~2013年12月该院收治的150例过敏性紫癜患儿,按照随机数表法分为普通组和治疗组,每组各75例,并选择同期50例健康儿童列为对照组。普通组患儿常规杜绝过敏原,行抗感染及钙剂、抗组胺等药物治疗;治疗组在普通组患儿治疗基础上使用肝素及双嘧达莫治疗,肝素(每天0.5~1 mg/kg)与葡萄糖(5%)静滴,双嘧达莫(每天4mg/kg)抗凝治疗。对比治疗前后3组儿童凝血酶时间(TT)、活化部分凝血时间(APTT)、血小板(PLT)等指标。结果:过敏性紫癜患儿TT异常率为29.33%(44例),D-二聚体异常率为20.67%(31例),APTT异常率为20.00%(30例),PT异常率为30.00%(45例),纤维蛋白原(Fbg)异常率为21.33%(32例),对照组全部正常。与对照组比较,差异均有统计学意义(χ2=24.215,18.051,17.995,25.014,18.137;P=0.001,0.000,0.001,0.000,0.001)。治疗组TT、D-二聚体、APTT、PT、Fbg、AT-Ⅲ、PLT改善均优于普通组,对比差异均有统计学意义(t=4.395,9.496,6.945,3.294,0.035,10.495,17.349;P=0.024,0.004,0.009,13.294,0.002,0.003,0.001));治疗组复发率为10.67%,与普通组比较,差异有统计学意义(χ2=7.215,P=0.008);治疗组紫癜病发率为5.33%,与普通组比较,差异有统计学意义(χ2=8.067,P=0.006)。结论:儿童过敏性紫癜体内高凝,早期抗凝可改善凝血状态,降低复发率及并发症发生率。
Objective: To investigate the coagulation status of children with Henoch-Schonlein purpura as well as the clinical significance of early anticoagulant therapy in children, so as to provide reference for clinical treatment. Methods: From January 2011 to December 2013, 150 children with Henoch-Schonlein purpura were enrolled in this hospital. According to the random number table, they were divided into general group and treatment group, 75 cases in each group, and 50 healthy children As a control group. General group of children routinely eliminate allergens, line anti-infective and calcium, antihistamine and other drugs; treatment group in the treatment of children with general treatment of heparin and dipyridamole treatment, heparin (0.5 ~ 1 mg / kg) and glucose (5%) intravenously, dipyridamole (4mg / kg daily) anticoagulant therapy. Thrombin time (TT), active partial clotting time (APTT) and platelet (PLT) were compared between the three groups before and after treatment. Results: The abnormal rate of TT in children with Henoch-Schonlein purpura was 29.33% (44 cases), the abnormal rate of D-dimer was 20.67% (31 cases), the abnormal rate of APTT was 20.00% (30 cases) and the abnormal rate of PT was 30.00% (45 cases). The abnormal rate of fibrinogen (Fbg) was 21.33% (32 cases). The control group was all normal. Compared with the control group, the differences were statistically significant (χ2 = 24.215,18.051,17.995,25.014,18.137; P = 0.001,0.000,0.001,0.000,0.001). The improvement of TT, D-dimer, APTT, PT, Fbg, AT-Ⅲ and PLT in the treatment group were all better than those in the normal group (t = 4.395,9.496,6.945,3.294,0.035,10.495, 17.349; P = 0.024,0.004,0.009,13.294,0.002,0.003,0.001)); The treatment group recurrence rate was 10.67%, compared with the normal group, the difference was statistically significant (χ2 = 7.215, P = 0.008); treatment group The incidence of purpura was 5.33%, compared with the normal group, the difference was statistically significant (χ2 = 8.067, P = 0.006). Conclusion: The hypercoagulability and early anticoagulation in children with Henoch-Schonlein purpura can improve the coagulation status and reduce the recurrence rate and the complication rate.