| Objectives:To observe the changes in platelet and coagulation indexes in children with refractory immune thrombocytopenia(ITP)treated with eltrombopag.To evaluate the clinical effect of eltrombopag in the treatment of children with refractory ITP,explore the safety of eltrombopag in children with ITP,and provide reference for the treatment of children with refractory ITP.Methods:This subject was a clinically controlled study.From September 2021 to September 2022,a total of 60 children with refractory ITP treated in the Pediatrics Department of Chifeng Hospital were selected.According to whether eltrombopag was used,the children were divided into eltrombopag group and IVIG group,each group had 30 children.The eltrombopag group was treated with eltrombopag.The IVIG group was treated with Intravenous immunoglobulin(IVIG).The platelet(PLT)levels in venous blood of the two groups of children were detected before treatment and on the 4,7,14,30,60 and 90 days of treatment.The levels of Prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)in the venous blood of the two groups of children before treatment and on the 30 and 90 days of treatment were detected.The changes in PLT and coagulation function(PT,APTT,FIB,D-D)levels of ITP children in the two groups were analyzed by statistical software.Discussing the relationship between the changes in the levels of each index and the application of eltrombopag.The therapeutic effect and safety of the two groups of children with ITP were evaluated.Results:1.Comparison of general conditions: There was no statistically significant difference between the two groups in gender,age,course of disease,and platelet count before treatment(P>0.05).2.Comparison of PLT between the two groups:(1)Intra-group comparison: In the eltrombopag group,the PLT in treated children at 7,14,30,60,and 90 days was higher than that before treatment,and the difference was statistically significant(P<0.05);in the IVIG group,the PLT in treated children at 4,7,14,30,60,and 90 days of was higher than that before treatment,and the difference was statistically significant(P<0.05).(2)Inter-group comparison: At 4,7,and 14 days of treatment,the PLT in the IVIG group was higher than the eltrombopag group;at 60 and 90 days of treatment,the PLT in the eltrombopag group was higher than IVIG group,the difference was statistically significant(P<0.05).3.Comparison of clinical effects: The total effective rate of the eltrombopag group was higher than the IVIG group at 30 days of treatment,the difference was not statistically significant(P>0.05).The total effective rate of the eltrombopag group was higher than that of the IVIG group at 60 and90 days of treatment,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no significant difference in the incidence of bleeding between the two groups before treatment(P>0.05).Comparing the incidence of bleeding between the two groups after90 days of treatment,the incidence of bleeding in the eltrombopag group was lower than that in the IVIG group,the difference was statistically significant(P<0.05).4.Comparison of coagulation function indexes between the two groups:(1)Before treatment,there was no statistically significant difference in PT,APTT,FIB,and D-D between the two groups(P>0.05).(2)PT,intra-group comparison: There was no statistically significant difference in PT between the eltrombopag group and the IVIG group after treatment compared with before treatment(P>0.05);inter-group comparison: there was no statistically significant difference in PT between the two groups after treatment(P>0.05).(3)APTT,intra-group comparison: the APTT of the eltrombopag group and the IVIG group was shortened after treatment compared with before treatment,and the difference was statistically significant(P<0.05);inter-group comparison: there was no statistically significant difference in APTT between the two groups after treatment(P> 0.05).(4)FIB,intra-group comparison: FIB in the eltrombopag group and IVIG group after treatment was higher than before treatment,and the difference was statistically significant(P<0.05);inter-group comparison: there was no statistically significant difference in FIB between the two groups after treatment(P>0.05).(5)D-D,intra-group comparison: D-D after treatment in the eltrombopag group and IVIG group compared with before treatment,the difference was not statistically significant(P>0.05);inter-group comparison: there was no statistically significant difference in D-D between the two groups after treatment(P>0.05).Conclusions:1.Eltrombopag is effective in the treatment of refractory ITP in children;it is more durable and effective in increasing platelets over time compared with IVIG;In the long-term treatment(more than 60 days),Eltrombopag has a better effect on increasing platelets and the better curative effect compared with IVIG.2.Compared with IVIG,Eltrombopag is more effective in reducing the risk of bleeding in children,and does not increase the incidence of adverse reactions in children.3.Eltrombopag has no adverse effect on the coagulation function of the children. |
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