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目的探讨丙种球蛋白联合地塞米松治疗特发性血小板减少性紫癜(ITP)患儿的疗效。方法 ITP患儿88例随机均分为两组,在基础治疗和糖皮质激素应用4周的基础上,分别加用人血丙种球蛋白200mg·kg~(-1)·d~(-1)(A组)或400mg·kg~(-1)·d~(-1)(B组)治疗,静脉输注,每天1次,连续5d。比较两组疗效、不良反应和住院治疗费用。结果治疗后3、6、9和14d,两组患儿血小板计数均上升(P<0.05)。A组治疗总有效率与B组相仿(97.7%vs.95.5%)(P>0.05)。治疗相关的主要不良反应为发热、静脉炎和过敏,A组不良反应发生率稍低于B组(6.8%vs.11.4%)(P>0.05)。A组住院治疗费用为(1.34±0.29)万元,低于B组的(2.41±0.43)万元(P<0.05)。结论联合应用地塞米松和丙种球蛋白治疗ITP均能取得良好疗效,但联合应用小剂量丙种球蛋白可减少治疗费用。
Objective To investigate the efficacy of gamma globulin combined with dexamethasone in children with idiopathic thrombocytopenic purpura (ITP). Methods A total of 88 children with ITP were randomly divided into two groups. On the basis of basic treatment and glucocorticoid treatment for 4 weeks, the levels of serum gamma globulin (200 mg · kg -1 d -1) Group A) or 400 mg · kg -1 (-1) (Group B). The rats were infused intravenously once daily for 5 days. The efficacy, adverse reactions and hospitalization costs of the two groups were compared. Results At 3, 6, 9 and 14 days after treatment, the platelet count of both groups increased (P <0.05). The total effective rate in group A was similar to that in group B (97.7% vs.95.5%) (P> 0.05). The main treatment-related adverse reactions were fever, phlebitis and allergy. The incidence of adverse reactions in group A was slightly lower than that in group B (6.8% vs.11.4%, P> 0.05). The cost of hospitalization in group A was (1.34 ± 0.29) yuan, which was lower than that in group B (2.41 ± 0.43) yuan (P <0.05). Conclusion The combination of dexamethasone and gamma globulin can achieve good results in the treatment of ITP, but the combination of low-dose gamma globulin can reduce the cost of treatment.