摘要
目的:探讨儿童疫苗接种后相关性特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)的临床表现。方法:收集我院2010-01～2016-12收治的疫苗接种后ITP患儿42例,针对患儿病情采用不同的方法治疗,并分析疫苗接种后ITP的临床表现。结果:接种的疫苗多为百白破、乙型肝炎、麻疹、脊髓灰质炎及流行性感冒/多价肺炎等,乙脑、流脑、风疹、水痘等疫苗少见。接种后3～7d发病者居多。患儿均有不同程度的自发出血,多为皮肤出血点、瘀斑,黏膜出血、鼻出血等,内脏出血极少见。所有患儿常规应用维生素C、氨肽素等治疗。中度ITP患儿口服强的松常规量治疗并逐渐减量;极重度患儿应用大剂量丙种球蛋白+甲基强的松龙冲击治疗。结论:疫苗接种后ITP是一过性自限性疾病,男性患儿居多,预后良好,且不影响疫苗的使用效果。疫苗制剂、接种监测机制的进一步完善可有效降低疫苗不良反应的发生。
Objective:To investigate the characteristics and prognosis of vaccination-related idiopathic thrombocytopenic purpura(ITP)in children.Methods:Forty-two children with vaccination-related ITP admitted in our hospital from January 2010 to December 2016 were enrolled.Different methods were used to treat the disease,and the clinical manifestations were analyzed.Results:Most vaccinations were pertussis-diphtheria-tetanus triple vaccine(DPT),hepatitis B,measles,polio and influenza/multivalent pneumonia,and vaccines like Japanese encephalitis vaccine,epidemic cerebrospinal meningitis,rubella,chickenpox were rare.The symptoms occurred after 3 to 7 days of inoculation.Spontaneous hemorrhage in different degrees occurred among the children,and most were skin bleeding points,mucosal hemorrhage and epistaxis,and visceral hemorrhage were rarely seen.All children were treated with vitamin C and aminopeptin.Children with moderate thrombocytopenia were gradually reduced after oral administration of prednisone,very severe children were treated with high-dose gamma globulin and methylprednisolone.Conclusion:Vaccination-related ITP is a transient selflimiting disease,mostly is male,with a good prognosis,and does not affect the effect of the vaccine.With further improvement of vaccine preparation and vaccination monitoring mechanism,the occurrence of adverse reactions of vaccines can be effectively avoided.
作者
王君霞
郭林梅
WANG Junxia;GUO Linmei(Department of Pediatrics,Lanzhou General Hospital of PLA,Lanzhou 730050,China)
出处
《西北国防医学杂志》
CAS
2018年第12期803-806,共4页
Medical Journal of National Defending Forces in Northwest China
基金
甘肃省自然科学基金资助项目(1506RJZA299)
