甲泼尼龙琥珀酸钠联合维生素D治疗过敏性紫癜患儿效果观察

李惠丽 廖康荣 邹兆城 王凯萍 林俊荣

【摘要】 目的：探讨分析甲泼尼龙琥珀酸钠联合维生素D治疗过敏性紫癜患儿的效果。方法：对2011年1月-2019年5月本院收治的92例过敏性紫癜患儿的临床资料进行回顾性分析。根据治疗方式不同将其分为观察组和对照组，每组46例。对照组给予甲泼尼龙琥珀酸钠治疗，观察组给予甲泼尼龙琥珀酸钠联合维生素D治疗。比较两组临床疗效、临床症状消失时间、住院时间、治疗前后免疫球蛋白水平及不良反应发生情况。结果：观察组治疗总有效率为95.65%，高于对照组的82.61%（P<0.05）。观察组皮疹、腹痛、关节肿痛消失时间及住院时间均短于对照组（P<0.05）。治疗后，两组IgA水平均低于治疗前，且观察组低于对照组（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：甲泼尼龙琥珀酸钠联合维生素D可提高过敏性紫癜患儿的治疗效果，缩短临床症状消失时间，改善免疫水平，值得临床推广。

【关键词】 甲泼尼龙琥珀酸钠 维生素D 过敏性紫癜

[Abstract] Objective： To investigate and analyze the effect of Methylprednisolone Sodium Succinate combined with Vitamin D in the treatment of children with Henoch-Schonlein purpura. Method： The clinical data of 92 children with Henoch-Schonlein purpura admitted to our hospital from January 2011 to May 2019 were retrospectively analyzed. According to different treatment methods， the patients were divided into observation group and control group， with 46 cases in each group. The control group was treated with Methylprednisolone Sodium Succinate， and the observation group was treated with Methylprednisolone Sodium Succinate combined with Vitamin D. The clinical efficacy， disappearance time of clinical symptoms， length of hospital stay， the level of immunoglobulin before and after treatment and the incidence of adverse reactions were compared between the two groups. Result： The total effective rate of the observation group was 95.65%， it was higher than 82.61% of the control group （P<0.05）. The disappearance time of rash， abdominal pain， joint swelling and pain and the length of hospital stay in the observation group were shorter than those in the control group （P<0.05）. After treatment， IgA levels in both groups were lower than those before treatment， and the observation group was lower than that of the control group （P<0.05）. There was no significant difference in the incidence of adverse reactions between two groups （P>0.05）. Conclusion： Methylprednisolone Sodium Succinate combined with Vitamin D can improve the therapeutic effect of children with Henoch-Schonlein purpura， shorten the disappearance time of clinical symptoms and improve the immune level， which is worthy of clinical promotion.

[Key words] Methylprednisolone Sodium Succinate Vitamin D Henoch-Schonlein purpura

First-authors address： Huizhou First Maternal and Child Health Hospital， Huizhou 516000， China

doi：10.3969/j.issn.1674-4985.2021.09.027

過敏性紫癜（HSP）是一种与血管病态有关的反应性疾病，学龄前和学龄期儿童为高发群体，发病后可累及肾脏、肝脏及消化道，病情严重的可诱发肾功能衰竭和肾病综合征等，并且HSP容易反复发作，对患儿的身心健康造成严重的危害，还给家庭带来经济负担[1-2]。HSP患儿常合并呕吐、腹痛等消化道症状，还会引起肠道出血。HSP发病机制尚未明确，临床上针对HSP的治疗主要以对症治疗为主[3-4]。本文旨在探讨分析甲泼尼龙琥珀酸钠联合维生素D治疗过敏性紫癜患儿效果，现报道如下。

1 资料与方法

1.1 一般资料 对2011年1月-2019年5月本院收治的92例过敏性紫癜患儿的临床资料进行回顾性分析。纳入标准：确诊为过敏性紫癜，符合《诸福棠实用儿科学》中关于过敏性紫癜的诊断标准[5];均为首次确诊;年龄2～12岁。……