Simons S M, Main C A, Yaish H M, Rutzky J
J Pediatr. 1975 Jul;87(1):16-22. doi: 10.1016/s0022-3476(75)80061-8.
Idiopathic thrombocytopenic purpura in children 10 years of age or younger was observed to have a more favorable prognosis than in older children. Corticosteroid therapy in children judged to be at increased risk of serious hemorrhage resulted in a significantly greater number of patients with an early increase in platelets than was noted in a control group. All patients with chronic disease who responded to administration of a corticosteroid initially and then relapsed had some response to a subsequent course of therapy, although none had a sustained remission. In such patients, splenectomy was a more effective therapeutic measure than treatment with either a corticosteroid or a cytotoxic agent.
观察发现,10岁及以下儿童的特发性血小板减少性紫癜预后比大龄儿童更佳。对于被判定有严重出血风险增加的儿童,皮质类固醇疗法导致血小板早期增加的患者数量显著多于对照组。所有患有慢性病且最初对皮质类固醇给药有反应但随后复发的患者,对后续疗程的治疗都有一定反应,尽管无人获得持续缓解。在这类患者中,脾切除术比皮质类固醇或细胞毒性药物治疗更有效。