儿童急性免疫性血小板减少症骨髓巨核细胞数与临床疗效的关系研究  

Correlation between Acute Megakaryocyte Counts of Immunethrombocytopenia Children and Curative Effect

作　　者：程杰[1] 

机构地区：[1]安徽省立儿童医院,安徽合肥230051

出　　处：《儿科药学杂志》2013年第5期23-25,共3页Journal of Pediatric Pharmacy

摘　　要：目的:观察儿童免疫性血小板减少症(immunethrombocytopenia,ITP)初诊时骨髓巨核细胞数量改变与疗效的关系,探讨巨核细胞数量的改变对急性ITP预后的估计及对治疗的指导作用。方法:将70例急性重度免疫性血小板减少症患儿,治疗前行骨髓细胞涂片检查,根据巨核细胞数量将其分为A、B、C三组,A组骨髓涂片巨核细胞数<7个/4.5 cm2,B组骨髓涂片巨核细胞为7～35个/4.5 cm2,C组>35个/4.5 cm2,分析三组激素治疗的疗效并进行比较分析。结果:三组患儿对激素冲击治疗反应不同,A组有效率25.0%,B组有效率76.5%,C组有效率93.3%,B、C两组分别与A组比较差异有统计学意义(P<0.05),C组有效率高于B组,两组比较差异有统计学意义(P<0.05)。结论:ITP患儿发病时骨髓细胞涂片,巨核细胞增殖明显者对激素、丙种球蛋白等治疗敏感,疗效好,恢复快;骨髓涂片巨核细胞不增多或减少者对激素、丙种球蛋白等治疗反应性差,应与家属沟通,及早采取其他联合治疗方法。Objective ： To observe the relationship between the change of megakaryocyte counts in bone marrow smear in children with immunethrombocytopenia （ITP） and the curative effect. This paper aims to discuss whether the changes of the megakaryocyte counts affect the prognosis of acute ITP and provide treatment guidance. Methods： Seventy cases of acute ITP were done bone marrow cells smear before treatment. According to the megakaryocyte counts, they were divided into group A, B, and C. The megakaryocyte counts of group A was 〈7/4.5 cm2, group B was 7 -35/4.5 cm2, and group C was 〉35/4.5 cm2. Analyze hormone therapy efficacy of the three groups, and make a comparative analysis. Results： The three groups had different response to hormone therapy. The curative effect of group A was 25.0%, group B was 76.5% and group C was 93. 3%. Compared with group A, there was a statistical significance in group B and C （ P〈0.05 ）. The curative effect of group C was better than that of group B, the difference was statistically significant （P〈0.05）. Conclusions： Children with acute ITP are sensitive to hormone and gamma globulin therapy, and will recover rapidly, when their megakaryocyte increases obviously. Patients, whose megakaryocyte does not increase or even decrease, are insensitive to hormone and gamma globulin therapy. For this kind of patients, we should communicate with their families, and choose other combination therapies as soon as possible.

关 键 词：免疫性血小板减少症 骨髓巨核细胞 儿童 

分 类 号：R725.5[医药卫生—儿科]