| 摘要: |
| [摘要]目的：研究不同血液灌流（HP）次数与甲泼尼龙剂量治疗重型腹型过敏性紫癜（HSP）患儿的疗效。方法：随机将55例重型腹型HSP患儿分为单用激素治疗组20例、3次HP+激素治疗组17例和单次HP+激素冲击组18例。单用激素治疗组给予甲泼尼龙常规剂量治疗，3次HP+激素治疗组使用血液灌流共3次，并给予甲泼尼龙常规剂量治疗。单次HP+激素冲击组给予1次血液灌流联合甲泼尼龙冲击递减疗法，观察并记录三组患儿的皮疹、腹痛、关节痛、呕吐、血便等临床症状的好转时间及住院时间，记录治疗前后三组的血清免疫球蛋白、血清补体及尿微量白蛋白和尿α1微球蛋白变化。结果：单次HP+激素冲击组和3次HP+激素治疗组的皮疹、腹痛、呕吐及血便、关节肿痛消退时间及住院时间均无显著性差异（P>0.05），但均明显优于单用激素组（P<0.05）；治疗后单次HP+激素冲击组和3次HP+激素治疗组的尿微量白蛋白和尿α1微球蛋白和血清IgE、IgA水平均明显降低（P<0.05），两组之间在治疗后无统计学差异(P>0.05)，单用激素组治疗前后尿微量白蛋白、尿α1微球蛋白和血清IgE、IgA无统计学差异（P>0.05）。三组患儿血清IgG、IgM、C3、C4水平治疗前后无统计学差异(P>0.05)。结论：对于无法完成多次HP的患儿，单次HP联合甲泼尼龙冲击递减疗法治疗重型腹型过敏性紫癜是可供选择的治疗办法。 |
| 关键词: 过敏性紫癜 血液灌流 甲泼尼龙冲击递减疗法 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.06.006 |
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| 基金项目: |
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| Different Times of Hemoperfusion and Different Doses of Methylprednisolone in the Treatment of Children with Severe Abdominal Henoch-Schönlein Purpura |
| Peng Zhe, Li Changjing, Feng Yan, Liu Yan, Jiang Jianyu, Xiong Daoxue, Liao Ruixue |
| (Chongqing Three Gorges Central Hospital, Chongqing 404000, China) |
| Abstract: |
| [Abstract] Objective: To study the efficacy of different times of hemoperfusion(HP) and doses of methylprednisolone in the treatment of children with severe abdominal Henoch-Schönlein purpura(HSP). Methods: Fifty-five children with severe abdominal HSP were randomly divided into single hormone treatment group (n=20), 3-times HP+hormone treatment group (n=17) and single HP+ hormone impaction group (n=18). Single hormone treatment group was given conventional dose therapy of methylprednisolone; 3-times HP+hormone treatment group received blood perfusion for 3 times and was additionally given conventional dose therapy of methylprednisolone; single HP+ hormone impaction group was treated with one hemoperfusion therapy combined with methylprednisolone impaction reduction therapy. The improvement time and hospitalization time of clinical symptoms for rash, abdominal pain, joint pain, vomit, bloody stool and hospitalization time were observed and recorded in 3 groups. Meanwhile, changes of levels of serum immunoglobulin, complement, urinary albumin and urinary α1 microglobulin were measured before and after treatment. Results: There was no significant difference between the single hormone treatment group and 3-times HP+hormone treatment group in disappearance time of rash, abdominal pain, vomit, bloody diarrhea and joint pain and hospitalization time(P>0.05), yet these two groups were significantly better than the single hormone treatment group (P<0.05). After treatment, the urine microalbumin, urine α1 and serum IgE, IgA levels in single HP+ hormone impaction group and 3-times HP+hormone treatment group decreased significantly(P<0.05), and there was no significant difference between two groups after treatment (P>0.05). There was no significant difference in urine microalbumin, urine α1 and serum IgE, IgA levels in single hormone treatment group before and after treatment (P>0.05). There was no significant difference in serum IgG, IgM, C3 and C4 levels among three groups (P>0.05). Conclusion: For children who cannot complete multiple HPs, a single HP combined with methylprednisolone impaction therapy for severe abdominal anaphylactoid purpura is an alternative treatment approach. |
| Key words: Henoch-Sch?nlein purpura hemoperfusion diminishing methylprednisolone impaction therapy |
