Clinical observation of the combined applications of high-dose intravenous immunoglobulin and dexamethasone to treating idiopathic thrombocytopenic purpura of children

Objective: To evaluate the effect of high-dose intravenous immunoglobulin(HDIVIG) and dexamethasone on treating acute and severe idiopathic thrombocytopenic purpura(ITP) of children.Methods: 36 severe ITP children whose blood platelet were less than 20×109/L and with obvious mucocutaneous hemorrhage were randomly divided into Group A and B with 18 cases in each group.Patients in Group A were treated with 1 g ·kg-1·d-1 HDIVIG for 1 day;1 mg·kg-1·d-1 dexamethasone for 3 successive days,and the dose was reduced to 0.5 mg·kg-1·d-1 until the 4th day for 2 successive days.Patients in the conventional dose treatment group(Group B) were treated with 0.4 g·kg-1·d-1HDIVIG and 0.4 mg ·kg-1·d-1dexamethasone for 5 successive days.Patients in both groups changed to take 1 mg ·kg-1·d-1 oral prednisone from the 6th day.Results: After the treatment,the time of the number of blood platelet of Group A and B reached above the safety line of 30×109/L was at the(1.2±0.3) and(2.3±0.4) days,50×109/L at the(2.1±0.4) and(3.2±0.5) days,and 100×109/L at the(4.2±0.6) and(6.5±1.1) days respectively,which were of statistical difference between the two groups(P0.05).Conclusion: The combined application of HDIVIG and dexamethasone to treating severe ITP has the advantages of increasing the blood platelet more quickly,better effect and lower cost,which is worth popularizing.