阿司匹林在儿童过敏性紫癜中的应用
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摘要
目的探讨阿司匹林对过敏性紫癜患儿预后的影响。方法选取2013年1月—2016年12月本院收治的过敏性紫癜患儿136例作为研究对象,随机分为对照组和实验组,每组各68例,另取同期来院检查的非HSP健康儿童200名中为空白对照组。实验组在对照组基础治疗的基础上加用阿司匹林3mg/kg,每天1次。检测患儿凝血指标以及肾功能并评价患儿临床治疗效果以及紫癜性肾炎发生率。结果实验组患儿PT、APTT与Fbg平均值均与空白对照有显著性差异;采用阿司匹林治疗的实验组患儿治愈28例,显效25例,有效12例,无效3例,有效率85.18%,显著高于对照组;最终发展为肾炎的,实验组共有6例(8.82%),低于对照组21例;患儿经过治疗,实验组PT平均增幅为(3.99±0.26) s,APTT平均增幅为(3.49±0.46) s,Fbg平均降幅为(0.64±0.05) mg/L,改变幅度均大于对照组(P<0.05);两组D-二聚体水平均有增加,但未表现出差异。结论阿司匹林能够明显改善患儿预后,尤其降低紫癜性肾炎的发病概率,其原因可能与凝血指标的改变有关。
Objective To investigate the effect of aspirin on the prognosis of children with HenochSchonlein purpura.Methods Totally 136 cases of children with allergic purpura,received therapy in the hospital during January 2013 and December 2016,were enrolled as study subjects. The experimental group was treated with aspirin 3 mg/kg once a day on the basis of basic treatment in the control group. The coagulation index and renal function were measured. Clinical therapeutic effect and incidence of Henoch-Schonlein purpura nephritis in children were evaluated. Results The average values of PT,APTT,and Fbg in the experimental group were significantly different from those in the blank control group. In the experimental group,28 cases were cured,25 cases were markedly effective,12 cases were effective and 3 cases were ineffective,the effective rate was 85.18%,which was significantly higher than that of the control group. There were 6 cases( 8. 82%) in the experimental group developed glomerulonephritis,which were lower than those in the control group( 21 cases).After treatment,the average increase of PT was( 3.99 ±0.26) s,the average increase of APTT was( 3.49±0.46)s,and the average decrease of Fbg was( 0. 64 ± 0. 05) mg/L,the changes in the experimental group were significantly higher than those of the control group( P< 0.05). The levels of D-dimer were increased in the two groups. However,there was no significant difference between the two groups. Conclusions Aspirin could improve the prognosis of children with HSP,especially reduce the incidence of purpura nephritis,the mechanism may relate to the change of coagulation indicators.
Objective To investigate the effect of aspirin on the prognosis of children with HenochSchonlein purpura.Methods Totally 136 cases of children with allergic purpura,received therapy in the hospital during January 2013 and December 2016,were enrolled as study subjects. The experimental group was treated with aspirin 3 mg/kg once a day on the basis of basic treatment in the control group. The coagulation index and renal function were measured. Clinical therapeutic effect and incidence of Henoch-Schonlein purpura nephritis in children were evaluated. Results The average values of PT,APTT,and Fbg in the experimental group were significantly different from those in the blank control group. In the experimental group,28 cases were cured,25 cases were markedly effective,12 cases were effective and 3 cases were ineffective,the effective rate was 85.18%,which was significantly higher than that of the control group. There were 6 cases( 8. 82%) in the experimental group developed glomerulonephritis,which were lower than those in the control group( 21 cases).After treatment,the average increase of PT was( 3.99 ±0.26) s,the average increase of APTT was( 3.49±0.46)s,and the average decrease of Fbg was( 0. 64 ± 0. 05) mg/L,the changes in the experimental group were significantly higher than those of the control group( P< 0.05). The levels of D-dimer were increased in the two groups. However,there was no significant difference between the two groups. Conclusions Aspirin could improve the prognosis of children with HSP,especially reduce the incidence of purpura nephritis,the mechanism may relate to the change of coagulation indicators.
引文
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[6]李有跃,华伟,刘福文,等.泼尼松、环磷酰胺等联合黄芪注射液治疗过敏性紫癜肾炎的临床研究[J].临床医药实践,2010,(16):1065-1067.
[7]中华医学会儿科学分会免疫学组,《中华儿科杂志》编辑委员会.儿童过敏性紫癜循证诊治建议[J].中华儿科杂志,2013,51(7):502-507
[8]刘元梅,郝冬荣.儿童过敏性紫癜凝血系列指标改变及早期抗凝治疗的意义[J].国际检验医学杂志,2017,(8):1134-1136
[2]吴天慧,李志辉,段翠蓉,等.3482例小儿过敏性紫癜流行病学分析[J].实用预防医学,2014,21(8):978-980.
[3]刘颖,罗敏,徐珽.阿司匹林肠溶片致过敏性紫癜1例[J].中国药物警戒,2016,13(4):249-250.
[4]黄进,张瑞麟,刘静,等.氨酚咖匹林片复方氨酚那敏颗粒致过敏性紫癜[J].空军医学杂志,2009,25(2):84.
[5]杨晓庆,沈彤.过敏性紫癜患儿凝血纤溶系统变化及抗凝治疗效果研究[J].中国全科医学,2016(S1):49-51.
[6]李有跃,华伟,刘福文,等.泼尼松、环磷酰胺等联合黄芪注射液治疗过敏性紫癜肾炎的临床研究[J].临床医药实践,2010,(16):1065-1067.
[7]中华医学会儿科学分会免疫学组,《中华儿科杂志》编辑委员会.儿童过敏性紫癜循证诊治建议[J].中华儿科杂志,2013,51(7):502-507
[8]刘元梅,郝冬荣.儿童过敏性紫癜凝血系列指标改变及早期抗凝治疗的意义[J].国际检验医学杂志,2017,(8):1134-1136