合并呼吸道感染的免疫性血小板减少症患儿上呼吸道分泌物RV、MP、SP检测及治疗效果观察  

Detection of RV,MP,and SP in upper respiratory tract secretions of children with immune thrombocytopenia complicated with respiratory tract infection and its therapeutic effect

作　　者：童琳琳 王立华[1] 方芳 许彬 郑素华 TONG Linlin;WANG Lihua;FANG Fang;XU Bin;ZHENG Suhua(Handan Central Hospital,Handan 056001,China;不详)

机构地区：[1]邯郸市中心医院,河北邯郸056001 [2]邯郸市传染病医院

出　　处：《山东医药》2020年第18期13-16,共4页Shandong Medical Journal

基　　金：河北省卫生厅科研基金资助项目(20191863)。

摘　　要：目的比较存在呼吸道病毒(RV)、肺炎支原体(MP)、链球菌(SP)感染的免疫性血小板减少症(ITP)患儿的治疗效果。方法268例合并呼吸道感染的ITP患儿,采集鼻咽分泌物标本,检测RV、MP;收集痰液标本,检测SP。对患儿进抗感染、静滴甲泼尼龙和(或)人免疫球蛋白等治疗。分别于治疗前、治疗后1周、治疗后2周及治疗后3个月检查并测算存在感染者白细胞计数(WBC)、C反应蛋白(CRP)及全血PLT。根据患者治愈时长和全血PLT计数判定其治疗效果,计算治疗总有效率。结果268例患儿中存在RV、MP、SP感染的分别为112、56、43例,RV、MP、SP感染在患儿中所占比例分别为41.2%、20.9%、16.0%、21.27%,与MP、SP感染患儿所占比例比较,RV感染患儿所占比例高(χ^2=43.21,27.19;P均<0.05)。与治疗前比较,治疗后各感染组血清PLT计数升高,且随治疗后时间延长血清PLT计数升高(P均<0.05);与MP、SP感染患儿比较,治疗后各时段RV感染患儿血清PLT计数升高(P均<0.05);与SP感染患儿比较,治疗后各时段MP感染患儿PLT计数升高(P<0.05)。RV、MP、SP感染患儿治疗总有效率分别为98.21%(110/112)、75.00%(42/56)、86.05%(37/43);与MP、SP感染患儿比较,RV感染患儿治疗总有效率高(P均<0.05);与SP感染患儿比较,治疗后MP感染患儿治疗总有效率低(P<0.05)。结论ITP合并上呼吸道感染患儿中RV感染占比最高,且治疗效果最好。ITP合并MP感染患儿的治疗效果最差。Objective To compare the therapeutic effects of immune thrombocytopenia(ITP)children with infections of respiratory virus(RV),mycoplasma pneumoniae(MP),and streptococcus(SP).Methods We collected 268 cases of children with ITP complicated with respiratory tract infection.The nasopharyngeal secretions of infected children were collected and tested for RV and MP;sputum samples were collected and SP was detected.The children were treated with anti-infection drugs,intravenous methylprednisolone and/or human immunoglobulin.Before treatment,1 w,2 w and 3 months after treatment,white blood cell count(WBC),C-reactive protein(CRP)and whole blood platelet count(PLT)were detected and calculated.The therapeutic effect was determined according to the cure time and the number of PLT in the whole blood,and the total effective rate was calculated.Results Among the 268 cases,RV was found in 112 cases,MP in 56,and SP in 43,respectively.The proportions of RV,MP and SP infections were 41.2%,20.9%,and 16.0%,respectively.Compared with the proportions of MP and SP infections,the proportion of RV infection was higher(χ^2=43.21,27.19;P<0.05).Compared with those before treatment,the content of serum PLT in each infection group increased after treatment,and the content of serum PLT increased over the course of treatment(both P<0.05).Compared with the children with MP and SP infections,the content of serum PLT in children with RV infection increased after treatment(P<0.05).Compared with the children with SP infection,the content of PLT in children with MP infection increased at each time point after treatment(P<0.05).The total effective rates of children with RV,MP and SP infections were 98.21%(110/112),75.00%(42/56),and 86.05%(37/43),respectively.Compared with children with MP and SP infections,the total effective rate of children with RV infection was higher(P<0.05);the total effective rate of children with MP infection after treatment was lower than that of children with MP infection(P<0.05).Conclusions RTP infection accounts for the hig

关 键 词：免疫性血小板减少症 呼吸道感染 呼吸道病毒 肺炎支原体 链球菌 

分 类 号：R554.6[医药卫生—血液循环系统疾病]