影响儿童特发性血小板减少性紫癜预后的相关因素调查分析  

Investigation and analysis on correlated influencing factors of prognosis of idiopathic thrombocytopenic purpura in children

作　　者：阮素琴 孙海英[1] 李娟[1] RUAN Su-Qin;SUN Hai-Ying;LI Juan(Department of Pediatrics,Zhejiang Taizhou Hospital,Taizhou,Zhejiang 317000,China)

机构地区：[1]浙江省台州医院儿内科

出　　处：《中国妇幼保健》2020年第2期311-313,共3页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划立项(2016KYB328)

摘　　要：目的探讨儿童特发性血小板减少性紫癜(ITP)的预后特点及其相关影响因素,为临床早期积极治疗和改善预后提供依据。方法对289例ITP患儿进行随访调查,依据预后转归将其分为治愈组和慢性组;分析ITP患儿预后转归特点,采用单因素比较法和多因素Logistic回归法分别筛选影响ITP患儿预后转归的相关危险因素。结果289例ITP患儿中的慢性发生率为24.91%(72/289);多因素分析结果显示,影响ITP转为慢性的危险因素包括发病年龄(OR=2.264)、病程(OR=1.790)、ORh(D)+(OR=4.411)及血小板恢复至正常时间(OR=1.640);而糖皮质激素(OR=0.668)、丙种球蛋白(OR=0.321)则为保护因素。结论ITP患儿通过积极综合治疗后仍有较高的慢性发生率,此类患儿预后效果较差;应针对以上高危因素早发现、早诊断、早治疗ITP急性期患儿,降低慢性发生率,改善患儿预后。Objective To explore the characteristics and correlated influencing factors of prognosis of idiopathic thrombocytopenic purpura(ITP)in children,provide a basis for clinical early and active treatment and improvement of prognosis.Methods A total of 289 children with ITP were followed up and surveyed,then they were divided into cure group and chronic group according to the prognosis of ITP.The characteristics of prognosis were analyzed,and the correlated influencing factors of prognosis of ITP were respectively screened by univariate analysis and multivariate Logistic regression analysis.Results The incidence rate of chronic prognosis of ITP was 24.91%(72/289).Multivariate analysis showed that the risk factors of adverse prognosis of ITP included age of onset(OR=2.264),course of disease(OR=1.790),ORh(D)+(OR=4.411),and the time of platelet recovery to normal level(OR=1.640),glucocorticoid(OR=0.668)and gamma globulin(OR=0.321)were protective factors.Conclusion After active and comprehensive treatment,the chronic occurrence rate of ITP is still high,the prognosis is not good.To directly aim at these above high-risk factors,early discovery,early diagnosis,and early treatment of ITP children at acute phase are necessary to reduce the chronic occurrence rate of ITP and improve prognosis of children with ITP.

关 键 词：儿童特发性血小板减少性紫癜 预后 影响因素 

分 类 号：R174[医药卫生—妇幼卫生保健]