82例儿童噬血细胞综合征检验指标分析及成分输血治疗  

Analysis of Laboratory Data of Children with Hemophagocytic Syndromes and Their Treatment by Blood Component Transfusion

作　　者：马曙轩[1] 徐樨巍[1] 宋文琪[1] 赵宇东[2] 靳剑芸[1] 邵华[1] 

机构地区：[1]首都医科大学附属北京儿童医院检验中心输血科,北京100045 [2]首都医科大学附属北京儿童医院心脏中心,北京100045

出　　处：《临床输血与检验》2013年第1期31-33,共3页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨噬血细胞综合征患儿检验指标变化及成分输血在该病支持治疗中的作用。方法将符合噬血细胞综合征诊断条件的患儿分为输血组和未输血组,统计分析患儿病原体检测结果,分别比较其白细胞计数、血红蛋白、血小板计数、丙氨酸氨基转移酶、单纯天冬氨酸转移酶、乳酸脱氢酶、甘油三酯、纤维蛋白原、部分凝血活酶时间及C-反应蛋白等结果,统计输血组不同ABO血型患儿输注成分血的品种和数量。结果在78.05%(64/82)的患儿体内检出病原体,其中巨细胞病毒感染占大多数(73.44%,47/64)。2组患儿的多项检验指标均有异常,输血组患儿的血红蛋白水平、血小板计数、纤维蛋白原含量、部分凝血活酶时间等检验指标较未输血组的差异有统计学意义(P<0.05)。其他检验指标的差异无统计学意义(P>0.05)。输血组患儿输注最多的血液成分是新鲜冰冻血浆(人均700ml),其次是悬浮红细胞(人均4.44U)。结论巨细胞病毒感染是导致噬血细胞综合征患儿发病的主要诱因,该病患儿为多脏器受累,多种检验指标严重异常。成分输血,尤其是新鲜冰冻血浆的输注在重症噬血细胞综合征患儿支持治疗中发挥了重要作用。Objective To research the range of laboratory data and the role of blood component transfusion in the treatment of children with hemophagocytic syndrome（HPS）. Methods The causative agents were analysed in all the patients. Children diagnosed with HPS were divided into two groups： transfusion group and non transfusion group. Childrent s laboratory data such as white blood cell count, hemoglobin, platelet count, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, triglyceride, fibrinogen, activated partial thromboplastin time and C-reactive protein were compared respectively. The amount of blood component transfusion was figured out. Results Causative agents were found in 78.05% （64/82） patients, of which the cytomegalovirus（CMV） infection were the most（73.44% ,47/64）. All the laboratory data in both groups was abnormal. The levels of hemoglobin, platelet count, fibrinogen, activated partial thromboplastin time in transfusion group had a significant difference compared with those in non transfusion group. But the other data had no significant difference. The most blood component transfused in transfusion group was fresh frozen plasma （700 ml/patient）. The second blood component transfused was red blood cells（4. 44 U/patient）. Conclusion CMV infection was the main causative agent in children with HPS. Multiple organ were damaged and lots of laboratory data ranged abnormally in children with HPS. Blood component transfusion, especially fresh frozen plasma transfusion play an important role in the treatment of children with HPS.

关 键 词：噬血细胞综合征 儿童 检验指标 成分输血 

分 类 号：R457.1[医药卫生—治疗学]