【摘要】 目的:观察甲泼尼龙联合孟鲁司特钠治疗小儿复发性过敏性紫癜的临床疗效。方法:选取我院2010年1月至2015年10月收治的89例复发性过敏性紫癜患儿,随机分为对照组Ⅰ28例、对照组Ⅱ29例和治疗组32例。三组均给予禁过敏饮食等常规治疗,对照组Ⅰ给予静脉滴注甲泼尼龙2~5 mg/kg,1次/天,连用3 d后减量,疗程5~7 d;对照组Ⅱ服用孟鲁司特钠咀嚼片,2~5岁每晚4 mg、6~14岁每晚5 mg,持续4周,合并消化道受累者应用地塞米松0.3~0.5 mg/(kg·d)静脉滴注,5~7 d后逐渐减量至停药;治疗组给甲泼尼龙联合孟鲁司特钠,用法用量同对照组。比较三组患儿症状缓解时间、住院时间、血清Ig A和IL-6的水平及复发率。结果:治疗组皮肤紫癜消失、关节痛缓解、腹痛缓解、血尿及蛋白尿消失时间及平均住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗2周后,三组患儿血清Ig A及炎性因子IL-6水平显著低于治疗前(P<0.05),且治疗组显著低于对照组(P<0.05)。对照组Ⅰ、Ⅱ和治疗组复发率分别为21.4%、17.2%、6.3%,总有效率分别为71.4%、75.9%、93.8%,三组复发率和总有效率比较差异均有统计意义(P<0.05);三组不良反应比较差异无统计学意义(P>0.05)。结论:甲泼尼龙联合孟鲁司特钠治疗小儿复发性过敏性紫癜的疗效较好,安全,能有效的缩短治愈时间,复发率低,值得临床推广应用。更多还原

【Abstract】 Objective: To observe the clinical efficacy of methylprednisolone combined with montelukast sodium on recurrent anaphylactoid purpurain in children. Methods: Eighty-nine children with recurrent anaphylactoid purpura were randomly divided into three groups treated with the forbidden allergic food and comprehensive treatment. The control group Ⅰ( 28 cases) was dripped methylprednisolone( 2 ~ 5 mg/kg,once a day for 3 days,3 days after reduction for 5 ~ 7 days); The control group Ⅱ( 29 cases) was given oral montelukast sodium( 2 ~ 5 years old 4 mg,6 ~ 14 years old 5 mg,1 time/night for 4 weeks). Merged the digestive tract involvement were treated with dexamethasone 0. 3 ~ 0. 5 mg/( kg·d) intravenous drip,gradually reduced to reduce stop in 5 ~ 7 days.The treatment group( 32 cases) was received methylprednisolone combined with montelukast sodium. The time of symptoms relief,hospitalization time,the levels of Ig A and IL-6,recurrence rate were observed before and after the treatment. Results: The time of skin purpura disappeared,joint pain relief,abdominal pain relief,hematuria and proteinuria disappeared and the average hospitalization days were shorter in the treatment group compared to the control group( P<0. 05). Two weeks after treatment,the levels of serum Ig A and inflammatory cytokines IL-6 of three groups were significantly lower than before treatment( P < 0. 05),the treatment group was significantly lower than two control groups( P< 0. 05). The recurrence rate of control group Ⅰ,control group Ⅱ and treatment group were 21. 4%,17. 2%,6. 3%,total effective rate were 71. 4%,75. 9%,93. 8%,there were statistically significant differences in three groups( P< 0. 05). The adverse effects of three groups were slightly( P > 0. 05). Conclusion: Methylprednisolone combine with montelukast sodium on recurrent anaphylactoid purpurain in children is safe and can reduce the healing time,recurrence rate,it is worthy of clinical application.更多还原