摘要
目的 分析儿童免疫性血小板减少症（ITP）的临床特征.方法 回顾性分析2012年7月至2015年6月280例资料完整并有随访记录的ITP患儿的临床资料,统计临床特征等相关数据并对单用激素、激素联合丙种球蛋白、单用丙种球蛋白三种不同治疗方案的治疗效果进行分析.结果 ①280例ITP患儿中新诊断、持续性、慢性各占63.93%、24.64%、11.43%,男女比例为1.5∶1;②起病诱因明确164例（58.57%）,发病季节以冬、春季节为主,发病年龄以婴幼儿为主,各年龄阶段男女比例比较差异未见统计学意义（P〉0.05）;③280例ITP患儿血小板呈不同程度减少,新诊断、持续性血小板以重度、极重度减少为主,慢性以中度、重度减少为主,三种分型ITP血小板减少程度比较差异有统计学意义（P〈0.01）;④新诊断、持续性、慢性ITP采用激素＋丙种球蛋白（IVIG）联合治疗总有效率分别为90.70%、72.72%、66.67%,差异有统计学意义（P〈0.05）.结论 ①儿童ITP以新诊断多见,持续性、慢性少见,发病年龄以婴幼儿为主;②半数以上患儿发病前有前驱感染史;③三种治疗方法均有效,激素联合丙种球蛋白对新诊断ITP疗效最明显.
Objective To analyze the clinical features of children with idiopathic thrombocytopenic purpura（ITP）.Methods The clinical data of 280 children with ITP between July 2012 to June 2015 were retrospectively analyzed.The clinical features of children were collected, and the clinical effect of the three different strategies of therapy （hormone alone, hormone combined with gamma globulin and gamma globulin alone） were analyzed.Results ①Among the 280 ITP children, newly diagnosed ITP, persistent ITP and chronic ITP accounted for 63.93%, 24.64% and 11.43% respectively.The ratio of male to female was 1.5∶1.②Among all cases, 164 cases（58.57%）had clear causes, the peak seasons were spring and winter.It occurred more commonly in infants and young children, the sex ratio showed no significant difference in these age periods （P〉0.05）.③The platelet of 280 children with ITP decreased to varying degrees, the platelet of new diagnostic, persistent were mainly severe;very severe, the platelet of chronic were mainly moderate, severe reduction.There was significant difference in the degree of platelet （P〈0.01）.④For newly diagnosed ITP, the efficiency of combination group was 90.70%, but it was lower in combination group in persistent ITP（72.72%） and chronic ITP（66.67%）.And there was significant difference among the three groups （P〈0.05）.Conclusions ①Newly diagnosed ITP is the most common type in pediatric ITP, while the chronic type is rare.The main onset age is in infancy.② More than half cases has prodromal infection histories.③Three treatment methods are effective, hormone combined with gamma globulin can obtain the best effect in the treatment of newly diagnosed ITP.
出处
《中国实用医刊》
2017年第11期66-69,共4页
Chinese Journal of Practical Medicine
