甲基强的松龙联合丙种球蛋白冲击治疗过敏性紫癜重症患儿疗效观察

目的探讨甲基强的松龙联合丙种球蛋白冲击治疗过敏性紫癜重症患儿的临床疗效。方法53例过敏性紫癜重症患儿随机分为2组。治疗组21例，采用甲基强的松龙15～30mg／（kg·d），加入5％葡萄糖150-200mL静脉点滴（1h内滴完），连续应用3d后改用琥珀酸氢化可的松10mg／（kg·d），加入5％葡萄糖150～250mL静脉点滴，连续应用10d，再予强的松1mg／（kg·d）晨顿服，逐渐减量至停用，疗程4周；甲基强的松龙冲击治疗的同时给予静脉用丙种球蛋白400mg／（kg·d）静脉点滴，疗程3～5d。对照组32例，给予琥珀酸氢化可的松10mg／（kg·d），加入5％葡萄糖150-250mL静脉点滴，连续应用14d，再予强的松1mg／（kg·d）晨顿服，逐渐减量至停用，疗程4周。观察2组皮疹、腹痛、消化道症状及关节症状消退时间。结果治疗组皮疹、腹痛、消化道症状及关节症状消退时间明显短于对照组（P〈0．01或P〈0．05），且治疗组住院天数较对照组明显缩短（P〈0．01）。结论甲基强的松龙联合丙种球蛋白冲击治疗过敏性紫癜重症患儿疗效显著，为临床治疗过敏性紫癜重症者提供了一个很好的选择。

Clinical Observation on Severe Henoch-Schonlein Purpura with the Pulse Therapy of Methylprednisolone and Inntravenous Immunoglobulin

Objective To explore the efficacy bined with intravenous immunoglobulin for child Methods Fifty-three child patients with severe of pulse therapy with methylprednisolone compatients with severe Henoch-Schonlein purpura. Henoch-Schonlein purpura were randomly divided into treated group （21 patients） and controlled group （32 patients）. Patients in treated group received methylprednisolone-15 - 30 mg/（kg · d）） ＋ 5 % GS 150 - 200 mL （i. v. gtt. , 1 h）] for three days followed by hydrocortisone sodium succinateF10 mg/（kg · d）＋5%GS 150-250 mL （i. v. gtt. ）7 for ten days,and then oral prednisone 1 mg/（kg · d） was followed and gradually reduced dose to stop, the total course of treatment was for 4 weeks;In the meantime, intravenous immunoglobulin -400 mg/（kg · d）, i. v. gtt. 3 was given for 3 - 5 days. While patients in controlled group were assigned to hydrocortis-one sodium succinat 10 mg/（kg · d）＋5%GS 150- 250 mL（i. v. gtt. ）7 for fourteen days followed by oral prednisone 1 mg/（kg · d）] and gradually reduce dose to stop,the total course of treatment was for 4 weeks. T test was used to compare the disappearing time of tetter, bellyache,symptom of alimentary tract and joint in these two groups. Results The disappearing time of tetter, bellyache, symptom of alimentary tract and joint was significantly shorter in treated group than that in controlled group （P〈0.01 or P〈0.05） ,as well as the time of hospitalization in treated group was also significantly shorter than that in controlled group （P〈0.01）. Conclusion Pulse therapy with methylprednisotone combined with intravenous immunoglobulin appears to be an effective treatment for child patients with severe Henoch--Schonlein purpura.