儿童急性特发性血小板减少性紫癜150例临床分析  

ANALYSIS OF CLINICAL FEATURES OF ACUTE IDIOPATHIC THROMBOCYTOPENIC PURPURA IN 150 CHILDREN

作　　者：许玉霞[1] 易志刚[1] 廖先华[1] 刘增荣[1] 方平[1] 

机构地区：[1]川北医学院附属医院儿科,南充637000

出　　处：《现代预防医学》2010年第17期3376-3377,共2页Modern Preventive Medicine

摘　　要：[目的]探讨儿童首次发病的特发性血小板减少性紫癜(Idiopathic Thrombo-cytopenic Purpura,ITP)的临床特征。[方法]回顾性分析及总结150例ITP患儿的临床表现,并分析及比较对症治疗、单用激素治疗及激素+IVIG治疗3组患儿的短期疗效。[结果]首次发病的儿童ITP患儿大多数可循前驱感染,临床主要表现为以不同程度的出血倾向,外周血血小板减少,骨髓颗粒未释放型巨核细胞比例显著增加,而成熟释放型巨核细胞比例显著减少。3组患儿总有效率分别为70%、82.1%、93.1%,4例对症治疗患儿血小板自行恢复,7例采用单用激素治疗和7例激素+IVIG治疗患儿无效。单用激素组和激素+IVIG组的两组患儿短期疗效差异有统计学意义。[结论]儿童急性ITP首次发病有独特临床特征,激素+IVIG治疗短期疗效优于单用激素治疗。[Objective] To explore clinical features of idiopathic thrombocytopenic purpura （Idiopathic Thrombo-cytopenic Purpura, ITP） in children. [ Methods] Retrospectively analyzed and concluded the clinical manifestations in 150 children with ITP and analyzed short-term efficacy of the three group that used symptomatic therapy, hormone therapy alone or hormone ＋ IVIG treatment. [Results] Most of the first onset of ITP in children followed precursor to infection; The main clinical manifestations of ITP were varying degrees of bleeding tendency, peripheral thrombocytopenia, particle type megakaryocytes in bone marrow were significantly increased, and mature megakaryocytes were significantly reduced; The total effective rate of 3 groups were respectively 70.0%, 82.1%, 93.1%, 4 cases used symptomatic treatment self-recoveried in platelets, 7 cases used alone hormone and 7 cases used hormone ＋ IVIG were refractory. The difference in short-term efficacy between two groups of alone hormone and hormone ＋ IVIG were significant. [Conclusion] Acute ITP in children on the first onset have some unique clinical features, hormone ＋ IVIG therapy can achieve better short-term efficacy than hormone therapy alone.

关 键 词：儿童 血小板减少性紫癜 自身免疫 

分 类 号：R554.6[医药卫生—血液循环系统疾病]