双嘧达莫联合他克莫司对激素耐药的过敏性紫癜患儿高凝状态及血清sICAM-1的影响

［摘要］ 目的 探讨双嘧达莫联合他克莫司对于激素耐药的过敏性紫癜患儿高凝状态及血清可溶性细胞间黏附分子1（soluble intercellular adhesion molecule-1,sICAM-1）的影响。 方法 选取90例过敏性紫癜患儿随机分为对照组和观察组各45例。对照组在常规治疗的基础上给予双嘧达莫、肝素治疗，观察组在对照组基础上联合他克莫司治疗。比较2组临床疗效、临床症状消失时间、治疗前后血凝指标及血清sICAM-1水平变化情况。 结果 观察组临床疗效和总有效率高于对照组（P＜0.05）；观察组关节肿痛、皮疹、腹痛等临床症状消失时间均明显短于对照组（P＜0.05）；治疗后观察组D-二聚体水平明显低于对照组，而凝血酶原时间、凝血酶时间、活化部分凝血时间水平明显高于对照组（P＜0.05）；治疗后观察组血清sICAM-1明显低于对照组（P＜0.05）。 结论 双嘧达莫联合他克莫司治疗激素耐药的过敏性紫癜患儿效果显著，能够明显改善机体血凝指标，抑制机体免疫反应，降低血清sICAM-1，有利于患儿症状的缓解。

Effects of Dipyridamole and Tacrolimus on high coagulation state and serum sICAM-1 in children with steroid-resistant Henoch-Schonlein purpura

［Abstract］ Objective To investigate the effects of dipyridamole and tacrolimus on high coagulation state and serum soluble intercellular adhesion molecule-1(sICAM-1) in children with steroid-resistant Henoch-Schonlein purpura. Methods Ninety children with steroid-resistant Henoch-Schonlein purpura were randomly divided into control group and observation group, 52 cases in each group. The control group received heparin combined with dipyridamole on the basis of routine treatment, and the observation group were given tacrolimus on the basis of control group. The clinical effect and the time of clinical symptom disappearance between the two groups were compared. And the changes of coagulation indexes and serum level of sICAM-1 before and after treatment were detected. Results The total effective rate of observation group was significantly higher than that of control group(P＜0.05). The clinical symptoms of joint swelling, rash and abdominal pain in the observation group were significantly shorter than those in the control group(P＜0.05). After treatment, the D-Dimer level of the observation group was significantly lower than that in the control group, while the prothrombin time, thrombin time and activated partial thromboplastin time levels were significantly higher than those in the control group(P＜0.05). The serum level of sICAM-1 in the observation group was significantly lower than that in the control group(P＜0.05). Conclusion Dipyridamole combined with tacrolimus in the treatment of steroid-resistant Henoch-Schonlein purpura children is significantly effective, it can significantly improve the blood coagulation index, inhibit the immune response, reduce serum sICAM-1, promote the remission of children′s symptoms.