儿童特发性血小板减少性紫癜疾病演变的探讨  

Evolvement of children idiopathic thrombocytopenic purpura beyond 6-months disease course

作　　者：吴润晖[1] 马洁[1] 周翾[1] 杨双[1] 马晓莉[1] 

机构地区：[1]北京儿童医院血液病中心,100045

出　　处：《中国小儿血液与肿瘤杂志》2008年第1期10-13,共4页Journal of China Pediatric Blood and Cancer

摘　　要：目的探讨儿童特发性血小板减少性紫癜的疾病演变情况，为判断预后、指导治疗提供依据。方法对2005年3月-2006年11月初发的特发性血小板减少性紫癜（ITP）231例临床资料进行总结、对比自然病程半年、1年、2年时缓解、复发患儿临床情况。结果其病程〉1年137例，〉2年41例。231人中慢性ITP比较年龄偏大、出血症状较重，多有前驱病史，〈6个月疾病缓解但〉6个月复发ll例（4．7％），发病年龄偏大、抗核抗体阳性、CDl9细胞％低；〉2年仍不缓解、复发患儿常规治疗效果不佳。结论儿童ITP病程6个月-2年内仍有高达30％的缓解率，切忌过度治疗；6个月-2年内复发比率低，常见于年长儿、抗核-抗体阳性、CDl9低的病人；〉2年仍不缓解、6个月后再次复发常规治疗效果不佳，需考虑选择进一步治疗。Objective Analyze .evolvement of Children Idiopathic Thrombocytopenic Purpura （ITP） beyond 6months disease course, for preview disease prognosis and further treatment. Methods Prospectively collected the data of ITP from Hematology Center, Beijing Children＇ s HOspital, March 2005 to Nov. 2006, analyze clinical data, compare remission prevalence and relapse in 6months, 1 year and 2 years after the first episode. Results Total patients were 231 cases, all of them 〉 6months, 137cases 〉 lyear, 41cases 〉 2years. （ 1 ） 22.6% couldn＇ t recover more than 6months diagnoses as CITE, （2） among CITP cases, 10cases （34. 5% ） remissed during 6months-lyear 3 cases（27.3%） during 1-2year： compare to AITP cases, they were older age, more mild bleed; but compare to un-remission patients, they were more prehistory. （3） Primary diagnosis was AITP, but 5 cases （4.7 % ） relapse during 6m-lyear： compare to remain remission patients： they were older age, more Anti-nuclear antibody（ANA） positive, higher level of CD19 T-cell%. （4） The patients who remained un-remission and relapse couldn＇ t gain the good result with the first-line therapy. Conclusion （ 1 ） There will be a high remission prevalence （30%） , of children ITP during 6m to 2 years, no hurry for more treatments. （2） Relapse prevalence was iow aurmg 6m-2y, more in older age, ANA （ ＋ ） and lower CD19%. （3） Cases of remain un-remission duringl-2y and relapse couldn＇ t receive the good result after the routine therapy, should choice the other therapy method.

关 键 词：儿童 特发性血小板减少性紫癜 演变 

分 类 号：R725.5[医药卫生—儿科]