儿童原发性免疫性血小板减少症的临床分析  

Clinical analysis of primary immune thrombocytopenia in children

作　　者：陈红[1] 黄玉柱[1] 杨惠泉[1] 田恒峰[1] 朱群英[1] 

机构地区：[1]安徽省蚌埠市儿童医院儿内科综合病区,233000

出　　处：《中国实用医刊》2015年第11期67-69,共3页Chinese Journal of Practical Medicine

摘　　要：目的临床分析儿童原发性免疫性血小板减少症（ITP）的临床特征及诊治结果。方法对蚌埠市儿童医院34例小儿ITP的临床特征及诊治结果进行分析。结果男：女=1．13：1，〈1岁16例（47．1％）；1—3岁9例（26．5％）。有前驱感染史15例（4J4．1％），血清肺炎支原体抗体阳性3例，巨细胞病毒感染3例；有疫苗接种史6例（17．6％）。临床特征最常见的是皮肤及黏膜下出血。重度出血4例（11．76％）。20例（58．81％）骨髓穿刺检查结果提示巨核细胞成熟障碍。抗感染药物、肾上腺皮质激素或联合使用IVIG的治疗方案，完全反应29例（85．29％），有效2例（5．88％），激素依赖1例（2．94％），无效2例。结论小儿ITP中婴幼儿的发病率高，新诊断类型居多；骨髓涂片细胞学检查对鉴别诊断有意义；激素为主的综合治疗疗效显著，预后良好。Objective To make a clinical analysis of the clinical features and results for childhood primary immune thrombocytopenia （ITP）. Methods The clinical characteristics and the results of diagnosis and treatment for 34 cases of childhood ITP were analyzed. Results Among the 34 cases, the ratio of male to female was 1.13： 1, 16 cases were under 1 year old （47. 1% ）, 9 cases were under 3 years old （26.5%）. 15 cases had precursor infection （44. 1% ）, 3 cases were positive in the mycoplasmal pneumonia antibody test. Three cases had positive HCMV-IgM antibodies. And 6 cases of onset after vaccinations（ 17.6% ）. Bleeding under the skin and mucous membrane was the most common clinic feature of the ITP patients. Four cases （ 11.76% ） had severe bleeding. The results of bone marrow puncture of 20 cases （58.81%） indicated megakaryocyte dysmaturity. Treatment protocols of anti infective agents, adrenal cortical hormone or combine with intravenous immune globulin（IVIG） were adopted. Out of the 34 cases, 29（85.29% ） had complete reaction, 2 cases （5.88%） were valid, and one steroid-dependent （2. 94% ） was not effective. Two cases had hospital transfer. Conclusions Morbidity of infant ITP is high in childhood ITP and newly diagnosed types are document. Bone marrow smear is significant for disease diagnosis and differential diagnosis. Therapeutic effects of comprehensive therapy with hormone are significant and prognosis is positive.

关 键 词：原发性免疫性血小板减少症 临床分析 儿童 

分 类 号：R558.2[医药卫生—血液循环系统疾病]