CAJ | 학술논문

目的临床分析儿童原发性免疫性血小板减少症(ITP)的临床特征及诊治结果.方法对蚌埠市儿童医院34例小儿ITP的临床特征及诊治结果进行分析.结果男∶女=1.13∶1,＜1岁16例(47.1％);1～3岁9例(26.5％).有前驱感染史15例(44.1％),血清肺炎支原体抗体阳性3例,巨细胞病毒感染3例;有疫苗接种史6例(17.6％).临床特征最常见的是皮肤及黏膜下出血.重度出血4例(11.76％).20例(58.81％)骨髓穿刺检查结果提示巨核细胞成熟障碍.抗感染药物、肾上腺皮质激素或联合使用IVIG的治疗方案,完全反应29例(85.29％),有效2例(5.88％),激素依赖1例(2.94％),无效2例.结论小儿ITP中婴幼儿的发病率高,新诊断类型居多;骨髓涂片细胞学检查对鉴别诊断有意义;激素为主的综合治疗疗效显著,预后良好.
목적 림상분석인동원발성면역성혈소판감소증(ITP)적림상특정급진치결과.방법 대방부시인동의원34례소인ITP적림상특정급진치결과진행분석.결과 남∶녀=1.13∶1,＜1세16례(47.1％);1～3세9례(26.5％).유전구감염사15례(44.1％),혈청폐염지원체항체양성3례,거세포병독감염3례;유역묘접충사6례(17.6％).림상특정최상견적시피부급점막하출혈.중도출혈4례(11.76％).20례(58.81％)골수천자검사결과제시거핵세포성숙장애.항감염약물、신상선피질격소혹연합사용IVIG적치료방안,완전반응29례(85.29％),유효2례(5.88％),격소의뢰1례(2.94％),무효2례.결론 소인ITP중영유인적발병솔고,신진단류형거다;골수도편세포학검사대감별진단유의의;격소위주적종합치료료효현저,예후량호.
Objective To make a clinical analysis of the clinical features and results for childhood primary immune thrombocytopenia (ITP).Methods The clinical characteristics and the results of diagnosis and treatment for 34 cases of childhood ITP were analyzed.Results Among the 34 cases,the ratio of male to female was 1.13∶ 1,16 cases were under 1 year old (47.1％),9 cases were under 3 years old (26.5％).15 cases had precursor infection (44.1％),3 cases were positive in the mycoplasmal pneumonia antibody test.Three cases had positive HCMV-IgM antibodies.And 6 cases of onset after vaccinations(17.6％).Bleeding under the skin and mucous membrane was the most common clinic feature of the ITP patients.Four cases (11.76％) had severe bleeding.The results of bone marrow puncture of 20 cases (58.81％) indicated megakaryocyte dysmaturity.Treatment protocols of anti infective agents,adrenal cortical hormone or combine with intravenous immune globulin(IVIG) were adopted.Out of the 34 cases,29(85.29％) had complete reaction,2 cases (5.88％) were valid,and one steroid-dependent (2.94％) was not effective.Two cases had hospital transfer.Conclusions Morbidity of infant ITP is high in childhood ITP and newly diagnosed types are document.Bone marrow smear is significant for disease diagnosis and differential diagnosis.Therapeutic effects of comprehensive therapy with hormone are significant and prognosis is positive.