儿童特发性血小板减少性紫癜病毒感染的临床分析

目的探讨儿童ITP病毒感染情况及其治疗与病情转归。方法(1)统计患儿发病的诱因,部分患儿检测EB病毒、巨细胞病毒、微小病毒B19、单纯疱疹病毒、支原体、自身抗体。分析病毒感染与ITP预后关系。(2)分析难治性与慢性TIP预后与治疗的关系。结果(1)病情严重程度与预后无关。(2)有特殊病毒感染诱因者共22例,其中12例(54.5%)为难治性或转为慢性;无特殊病毒感染诱因者共77例,其中19例(24.7%)为难治性或慢性,差异有显著性(P<0.05)。(3)难治性ITP转慢性的12例治疗效果均欠佳。(4)慢性ITP有特殊病毒感染者6例,其中好转的4例均多次短期大剂量应用丙种球蛋白,此4例中的3例同时或之前应用抗病毒药物,2例应用肾上腺皮质激素冲击。无特殊病毒感染史者13例,治疗好转6例,无效6例,均未应用大剂量丙种球蛋白。结论由特殊病毒感染引起的儿童ITP预后欠佳,加强联合大剂量丙种球蛋白、抗病毒的力度可改善预后。

The clinical analysis of virus infection in children with ITP

Objective To study virus infection in children with idiopathic thrombocytopenic purpura(ITP)and the treatment 、prognosis. Methods(1)The cause of ITP was investigated EB virus(EBV)、Cytomegalovirus(CMV)、Human parvovirus B19(HPVB19)、herpes simplex virus(HSV)、mycoplasma(MP)IgG and self antibody were detected.(2) The relation between treatment and progonosis of chronic ITP and refractory ITP was analysed. Results(1)There wasn't any relation between the severity degree and prognosis.(2) The difference between special virus infection and prognosis was significant.(3) In the 12 cases changing from refractory to chronic ITP,no difference was observed in patients with virus infection and treatment.(4) In chronic ITP,virus infection and insufficient γ globulin led to poor prognosis.Conclusion Prognosis of ITP led by special virus infections in children are poor.Strengthened combined protocols by high-dose γ globulin and antivirus treatment can improve prognosis.