儿童免疫性血小板减少症的临床观察及抗核抗体在其中作用的研究  

Clinical Observation of Children with Immune Thrombocytopenia and the Study of the Effect of ANA/ANAs in the Disease

作　　者：郑静娴 李晓辉[1] 孙洪强 ZHENG Jing-xian;LI Xiao-hui;SUN Hong-qiang(The First Affiliated Hospital of Harbin Medical University,150000)

机构地区：[1]哈尔滨医科大学附属第一医院,150000

出　　处：《临床输血与检验》2021年第2期231-235,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨本地区儿童免疫性血小板减少症(ITP)的发病特征、不同选择治疗疗效及抗核抗体(ANA)/抗核抗体谱(ANAs)在疾病中的作用。方法回顾性研究2017年2月~2019年1月在我院住院的204例初发儿童ITP患者的发病特点,对其中135例可随访患儿按丙种球蛋白治疗或对症治疗、ANA/ANAs阳性或阴性分类,比较不同类别的基本特征及治疗反应。结果丙球治疗组患者初始血小板计数低于对症治疗组,ANA/ANAs阳性率、入院第5天血小板升高值、完全反应率、总反应率高于对症治疗组,慢性率比较无差异。ANA/ANAs阳性患者初始血小板计数低于阴性患者,丙球治疗的ANA/ANAs阳性患者入院第5天血小板升高值、完全反应率低于阴性患者,血小板升至正常时间长于阴性患者,总反应率及慢性率比较无差异。结论在儿童ITP治疗中,丙球可快速升高血小板,但长期反应未见优势。ANA/ANAs阳性的患者的治疗反应差于阴性患者,有必要早期进行更积极的治疗。Objective To explore the characteristics,the effect of different treatments,and the role of antinuclear antibody/antinuclear antibody spectrum(ANA/ANAs)of immune thrombocytopenia(ITP)in children.M e t h o d s We retrospectively analyzed the characteristics of 204 children with new-onset ITP in the First Affiliated Hospital of Harbin Medical University from February 2017 to January 2019.Among them,135 cases who could be followed up were classified according to intravenous immunoglobulin(IVIg)or symptomatic treatment,ANA/ANAs positive or negative.The basic characteristics and treatment response of different groups were compared.Results The initial platelet count of the patients treated with IVIg was lower than that in symptomatic treatment group,and the platelet elevation,complete response rate(CR),overall response(CR+R)rate and ANA/ANAs positive rate were higher than those in the symptomatic treatment group,but there was no difference in the chronic rate.The initial platelet count of patients with ANA/ANAs positive was lower than that of negative patients.On the 5th day after admission,the platelet elevation and CR rate of patients with ANA/ANAs positive treated with IVIg were lower than those of negative patients.The time of platelet elevation to normal in ANA/ANAs positive patients was longer.There was no difference between the CR+R rate and chronic rate.Conclusion In the treatment of children ITP,IVIg can rapidly increase platelets,but there is no advantage in long-term response.The treatment response of ANA/ANAs positive patients is worse than that of negative patients,so it is necessary to take more active treatment in the early stage.

关 键 词：儿童免疫性血小板减少症 丙种球蛋白 对症治疗 抗核抗体 抗核抗体谱 

分 类 号：R446.6[医药卫生—诊断学]