目的 研究雙嘧達(dá)莫聯(lián)合甲基強(qiáng)的松治療小兒過敏性紫癜的臨床效果。方法 選取2012年8月-2014年8月延安大學(xué)附屬醫(yī)院兒科收治的過敏性紫癜患兒80例,隨機(jī)分為對照組和治療組,每組各40例。對照組靜脈滴注注射用甲潑尼龍琥珀酸鈉,第1~3天20 mg/(kg·d)加入到5%葡萄糖溶液150 mL中2 h內(nèi)滴注完成;以后每3天劑量減半,待患兒病情穩(wěn)定后改為口服醋酸潑尼松片2.0 mg/(kg·d),2周后改為1.0 mg/(kg·d)。治療組在對照組治療基礎(chǔ)上口服雙嘧達(dá)莫片,3.0 mg/(kg·d)。兩組均連續(xù)治療6個月。觀察兩組的臨床療效,同時比較兩組腎損害消失時間、腹痛消失時間、關(guān)節(jié)腫痛消失時間、消化道出血消退時間、皮疹消退時間、住院時間。結(jié)果 治療后,對照組和治療組的總有效率分別為75.0%、97.5%,兩組比較差異有統(tǒng)計學(xué)意義(P < 0.05)。治療組患兒的腎損害消失時間、腹痛消失時間、關(guān)節(jié)腫痛消失時間、消化道出血消退時間、皮疹消退時間、住院時間均顯著短于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P < 0.05)。結(jié)論 雙嘧達(dá)莫聯(lián)合甲基強(qiáng)的松治療小兒過敏性紫癜具有較好的臨床療效,能有效改善患者的臨床癥狀和體征,提高患者治療的總有效率,具有一定的臨床推廣應(yīng)用價值。

Objective To study the clinical effect of dipyridamole combined with methylprednisolone in treatment of infantile allergic purpura. Methods Patients (80 cases) with allergic purpura in Department of Pediatrics of Yanan University Affiliated Hospital from August 2012 to August 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were iv administered with Methylprednisolone Sodium Succinate for injection 20 mg/(kg·d) which was added into 5% glucose solution 150 mL in 2 h for the first day to the third day, and the dosage was in half every 3 d. They were po administered with Prednisone Acetate Tablets 2.0 mg/(kg·d)until the children were in stable condition, and the dosage was 1.0 mg/(kg·d) after two weeks. The patients in the control group were po administered with Dipyridamole Tablets on the basis of the control group, 3.0 mg/(kg·d). Two groups were treated for six months. After treatment, the efficacy was evaluated, and the changes of kidney damage disappearance time, abdominal pain disappearance time, joint swelling and pain disappeared time, gastrointestinal bleeding subsided time, rash subsided time, and hospital stay time in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 75.0% and 97.5%, respectively, and there were differences between two groups (P < 0.05). After treatment, kidney damage disappearance time, abdominal pain disappearance time, joint swelling and pain disappeared time, gastrointestinal bleeding subsided time, rash subsided time, and hospital stay time in treatment group were shorter than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Dipyridamole combined with methylprednisolone has good clinical curative effect in treatment of infantile allergic purpura, and can effectively improve the clinical symptoms and signs, also can improve the overall efficiency, which has a certain clinical application value.