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目的观察激素治疗特发性血小板减少性紫癜(ITP)的疗效及少见不良反应,为临床选择慢性ITP的治疗策略提供参考。方法总结1例典型ITP患儿的治疗经过,规范随访血小板的变化情况,监测、记录激素治疗过程中的不良反应。结果初期患者对激素治疗反应较敏感,血小板上升至正常,在激素减量过程中血小板下降,由于血小板波动而更换不同的糖皮质激素,并因此长期应用激素口服治疗,治疗过程中患者继发严重库欣综合征及高血压,并出现脑梗死的临床表现及典型影像学改变。结论长期应用激素对慢性ITP的升血小板作用有限,而不良反应较大,对于规范激素治疗无效的病例应采取密切观察和等待的策略。
Objective To observe the curative effect and rare adverse reactions of steroid therapy for idiopathic thrombocytopenic purpura (ITP), and to provide a reference for clinical treatment of chronic ITP. Methods One case of typical ITP children was treated, the follow-up of platelet changes was monitored, and adverse reactions during hormone therapy were recorded and recorded. Results The initial response to hormone therapy is more sensitive to platelets rose to normal in the process of hormone reduction in platelets decreased due to platelet fluctuations in the replacement of different glucocorticoid and therefore long-term use of oral hormones, the treatment of patients with secondary serious Cushing’s syndrome and hypertension, and the clinical manifestations of cerebral infarction and typical imaging changes. Conclusion Long-term use of hormones on platelet ITP has a limited role, but adverse reactions, for the regulation of ineffective hormone therapy should take close observation and wait for the strategy.