内蒙古地区儿童原发性免疫性血小板减少症临床特征分析—来自12家中心的队列研究  

Clinical characteristics of primary immune thrombocytopenia in children in Inner Mongolia

作　　者：武奇 王向文 侯慧 张称心[3] 萨初然贵[4] 王艳军 宁立华 萨日娜[6] 经鑫爱[7] 陈强 朱君 李朝晖[10] 荣灵瑜 刘领灵 肖娟[13] 张躲 WU Qi;WANG Xiangwen;HOU Hui;ZHANG Chenxin;SA Churangui;WANG Yanjun;NING Lihua;Sarina;JING Xinai;CHEN Qiang;ZHU Jun;LI Zhaohui;RONG Lingyu;LIU Lingling;XIAO Juan;ZHANG Duo(Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;Department of Pediatric Hematology,Inner Mongolia Autonomous Region People′s Hospital,Hohhot 010010,China;Department of Pediatrics,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010010,China;Department of Pediatrics,Chifeng Hospital of Inner Mongolia,Chifeng 024005,China;Department of Pediatrics,Fourth Hospital of Baotou,Inner Mongolia,Baotou 014040,China;Department of Pediatrics,Ordos Central Hospital,Ordos 017000,China;Department of Pediatrics,The First Affiliated Hospital of Baotou Medical College,Baotou 014040,China;Department of Pediatrics,Inner Mongolia Baotou Central Hospital,Baotou 014040,China;Department of Pediatrics,Hulunbuir City Hospital,Hulunbuir 021000,China;Department of Pediatrics,Bayannaoer City Hospital,Bayannaoer 015000,China;Department of Pediatrics,Xilingol League Central Hospital,Xilin Hot 026000,China;Department of Pediatrics,Inner Mongolia Xingan League People′s Hospital,Ulanhot 137400,China;Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]内蒙古科技大学包头医学院,包头014040 [2]内蒙古自治区人民医院小儿血液科,呼和浩特010010 [3]内蒙古医科大学附属医院儿科,呼和浩特010010 [4]内蒙古赤峰市医院儿科,赤峰024005 [5]内蒙古包头第四医院儿科,包头014040 [6]鄂尔多斯市中心医院儿科,鄂尔多斯017000 [7]包头医学院第一附属医院儿科,包头014040 [8]内蒙古包头中心医院儿科,包头014040 [9]内蒙古呼伦贝尔市医院儿科,呼伦贝尔021000 [10]内蒙古巴彦淖尔市医院儿科,巴彦淖尔015000 [11]内蒙古锡林郭勒盟中心医院儿科,锡林浩特026000 [12]内蒙古兴安盟人民医院儿科,乌兰浩特137400 [13]中国医学科学院北京协和医院,北京100730

出　　处：《中国小儿血液与肿瘤杂志》2024年第4期240-248,共9页Journal of China Pediatric Blood and Cancer

基　　金：中央高水平医院临床科研专项项目,编号:2022-PUMCH-C-040;内蒙古自治区卫生健康科技计划项目,编号202201063。

摘　　要：目的探讨儿童原发性免疫性血小板减少症(ITP)的临床特征,为进一步揭示其发病机制和更精准的分层诊疗提供依据,同时带动提升内蒙古地区ITP规范诊疗。方法通过多中心回顾性队列研究,分析内蒙古自治区人民医院等内蒙古地区12家医院近6年收治的632例ITP患儿的临床资料,根据年龄分组,通过单因素方差分析得出不同年龄段患儿的临床特点。结果纳入研究的316例患儿中,不同年龄段的患儿在性别、ICR出血分级、黏膜出血、发病诱因、初诊PLT计数、MPV、ANA、A-ENA、免疫球蛋白、骨髓巨核细胞总数、骨髓粒系比例、不同的治疗方式及治疗后1、3、6、12个月的治疗效果、ITP的分型中具有统计学意义;发病季节、补体水平差异无统计学意义。结论内蒙古地区儿童ITP发病高峰在4~18岁段,随年龄的增长女性逐渐多于男性;鼻黏膜出血占比、初诊PLT计数及MPV升高、ANA+、A-ENA+、免疫球蛋白水平升高、骨髓巨核细胞总数增高、骨髓粒系比例升高、GC+IVIG治疗、进展为慢性比率较高多分布在4~18岁组;<1岁组有起病诱因占比高于另外两组,且在第1、3、6、12个月的完全缓解率均高于另外2组。Objective To explore the basic clinical characteristics of primary immune thrombocytopenia(ITP)in children,provide a basis for further exploration of pathogenesis and more accurate hierarchical diagnosis and treatment,and promote the improvement of the standardization of diagnosis and treatment in this region.Methods The clinical data of 632 children with ITP treated in 12 hospitals including the People′s Hospital of Inner Mongolia Autonomous Region in recent 6 years were collected and divided into 3 groups according to age.The clinical characteristics of the children in different ages were obtained by one-way ANOVA.Results Among the 316 children included in the statistics,There were significant differences in gender,ICR bleeding grade,mucosal bleeding,pathogenesis,PLT count at first diagnosis,MPV,ANA,A-ENA,immunoglobulin,total number of bone marrow megakaryocytes,proportion of bone marrow granules,different treatment methods,treatment effect at 1,3,6 and 12 months after treatment,and ITP classification in children of different ages.The season of onset and complement had no statistical significance.Conclusions In Inner Mongolia,ITP occurred in children aged from 4 to 18 years,and the number of females was higher than that of males.The proportion of nasal mucosal hemorrhage,PLT count and MPV value increased at first diagnosis,ANA+,A-ENA+,immunoglobulin(IgA,IgG,IgM)levels increased,the total number of bone marrow megakarocytes increased,the proportion of bone marrow granules increased,GC+IVIG combined use,and cITP ratio were more common in children aged 4-18 years.The<1 year old group had a higher proportion of onset causes than the other two groups,and the complete remission rate at 1,3,6 and 12 months was higher than the other two groups.

关 键 词：儿童 原发性免疫性血小板减少症 临床特征 内蒙古 

分 类 号：R725.5[医药卫生—儿科]