免疫性血小板减少症299例自身抗体表达及预后影响因素分析  

Analysis of autoantibody expression and prognostic factors of immune thrombocytopenia in 299 children

作　　者：徐龙伟 曹峰 张耀东 张迎辉 XU Longwei;CAO Feng;ZHANG Yaodong;ZHANG Yinghui(Children's Hospital Affiliated to Zhengzhou University,Henan children's Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院,河南郑州450000

出　　处：《临床儿科杂志》2024年第4期318-322,共5页Journal of Clinical Pediatrics

摘　　要：目的分析免疫性血小板减少症(ITP)患儿自身抗体表达特点及预后影响因素。方法回顾性分析2020年9月—2021年9月住院的初诊ITP患儿的临床资料。结果纳入299例ITP患儿,男171例、女128例,中位年龄2.7(1.0~4.6)岁。完成自身抗体谱检测的296例ITP患儿中,自身抗体谱表达阳性114例(38.5%),其中抗核抗体阳性101例(88.6%),抗SSA/RO52KD抗体阳性59例(51.8%),抗SSA/RO60KD抗体阳性52例(45.6%)。299例ITP患儿中205例治愈。与治愈组相比,未治愈组年龄≥1岁,抗核抗体、抗SSA/RO52KD抗体、抗SSA/RO60KD抗体阳性以及出血评分≥3分的比例较高,前驱感染和单用丙种球蛋白的比例较低,差异有统计学意义(P<0.05)。二分类logistics回归分析结果显示年龄≥1岁,抗核抗体阳性,出血评分≥3分是影响ITP预后的独立危险因素(P<0.05),有前驱感染史是影响ITP预后的独立保护因素(P<0.05)。结论ITP患儿自身抗体谱抗体表达常见。年龄、前驱感染史、抗核抗体及出血评分与ITP预后有关。Objective To analyze the characteristics of autoantibody expression and prognosis influencing factors in children with immune thrombocytopenia(ITP).Methods The clinical data of 299 children with newly diagnosed ITP hospitalized from September 2020 to September 2021 were retrospectively analyzed.Results A total of 299 children(171 boys and 128 girls)with ITP were included,and the median age was 2.7(1.0-4.6)years.Among the 296 ITP children who completed autoantibody spectrum detection,114(38.5%)showed positive autoantibody spectrum expression.One hundred and fourteen patients(38.5%)of the 296 ITP children who finished autoantibody spectrum detection had positive autoantibody spectrum expression.Among them,101 patients(88.6%)were positive for anti-nuclear antibody,59(51.8%)were positive for anti-SSA/RO52KD antibody,and 52(45.6%)were positive for anti-SSA/RO60KD antibody.Of 299 children with ITP,205 were cured.Compared with the cured group,the uncured group had a higher proportion of age≥1 year old,positive antinuclear antibody,anti-SSA/RO52KD antibody,anti-SSA/RO60KD antibody and bleeding score≥3,and a lower proportion of preceding infection and gammaglobulin alone,with statistically significant differences(P<0.05).The binary logistics regression analysis showed that age≥1 year old,positive antinuclear antibody,and bleeding score≥3 were independent risk factors for ITP prognosis(P<0.05),and a history of preceding infection was an independent protective factor for ITP prognosis(P<0.05).Conclusions Autoantibody spectrum antibody expression is common in children with ITP.Age,history of preceding infection,antinuclear antibody and bleeding score are associated with ITP prognosis.

关 键 词：免疫性血小板减少症 儿童 自身抗体 预后因素 

分 类 号：R725.5[医药卫生—儿科] R446.6[医药卫生—临床医学]