儿童原发性免疫性血小板减少症凝血功能分析  

Analysis of Coagulation Function in Children with Primary Immune Thrombocytopenia

作　　者：尹萌萌[1] 刘爱国[1] 张艾[1] 王雅琴[1] 胡群[1] Yin Mengmeng;Liu Aiguo;Zhang Ai(Department of Pediatric Hematology,Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Hubei 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院儿童血液科,武汉430030

出　　处：《医学研究杂志》2021年第5期104-107,共4页Journal of Medical Research

摘　　要：目的研究原发性免疫性血小板减少症儿童(primary immune thrombocytopenia,ITP)凝血功能改变及临床意义。方法检测558例ITP患儿血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)等凝血功能变化,并结合出血症状分析其临床意义。结果本组ITP儿童中,无出血81例,出血477例,其中轻度出血283例,中度出血178例,重度出血16例;PLT数不同的患儿出血症状不同(P=0.000);不同APTT、PT的患儿出血症状比较,差异无统计学意义;部分患儿的AT-Ⅲ、FVⅢ及FⅨ活性结果异常;不同FIB浓度的患儿出血症状不同,ROC曲线分析中,FIB对患儿出血具有诊断价值,最佳临界值为2.7g/L;Logistic回归分析中,患儿出血症状与性别(OR=0.93,95%CI:0.81~1.06)及年龄(OR=0.83,95%CI:0.34~2.03)无关,与PLT(OR=0.32,95%CI:0.19~0.55)及FIB(OR=0.08,95%CI:0.024~0.280)有关。结论ITP儿童出血症状与PLT数有关,与APTT及PT无关;部分ITP儿童凝血功能异常,建议ITP患儿诊断时常规筛查凝血功能;FIB浓度与ITP儿童出血症状有关,通过输注FIB可能缓解ITP患儿出血。Objective To study the changes and clinical significance of coagulation function in children with primary immune thrombocytopenia(ITP).Methods The platelet(PLT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and so on were detected in 558 children with ITP.The clinical significance was analyzed according to the bleeding situation of children.Results There were 81 cases without bleeding and 477 cases with bleeding,including 283 cases with mild bleeding symptoms,178 cases with moderate bleeding and 16 cases with severe bleeding.The bleeding symptoms were different in children with different PLT(P=0.000).The bleeding symptoms were not different in children with different APTT and PT.The results of AT-Ⅲ,FVⅢand FⅨactivity were abnormal in some children.The bleeding symptoms of children with different FIB concentrations were different.In ROC curve analysis,FIB had diagnostic value for children with bleeding.The optimal critical value was 2.7g/L.In Logistic regression analysis,symptoms of bleeding in ITP children was irrelevant to gender(OR=0.93,95%CI:0.81-1.06)and age(OR=0.83,95%CI:0.34-2.03),but it was relevant to PLT(OR=0.32,95%CI:0.19-0.55)and FIB(OR=0.08,95%CI:0.024-0.280).Conclusion The bleeding symptoms in ITP children were associated with PLT count,not with APTT and PT.Some ITP children with abnormal coagulation function,it is recommended to routinely screen coagulation function of ITP children.The concentration of FIB is associated with bleeding symptoms in ITP children,and it is possible to relieve ITP emergency bleeding by infusion fibrinogen.

关 键 词：原发性免疫性血小板减少症 儿童 血小板 凝血功能 出血症状 

分 类 号：R72[医药卫生—儿科]