小儿白细胞及中性粒细胞减少症331例相关因素分析与探讨

目的探讨小儿白细胞及中性粒细胞减少的临床特点及相关因素，为其防治提供依据。方法收集2002年1月至2009年8月在我院儿科住院治疗的331例白细胞及中性粒细胞减少症病例，对其临床资料、实验室检查、治疗及预后进行回顾性分析。结果①婴幼儿及学龄前期发病占83．69％；男女发病比例为1．88：1。②白细胞和中性粒细胞减少有四种类型：a、白细胞总数和中性粒细胞数同时减少（54．68％）；b、白细胞总数正常，淋巴细胞比率明显增高〉75％，中性粒细胞数减少（25．98％）；c、白细胞总数减少，分类正常，中性粒细胞数可减少或正常（13．29％）；d、白细胞数减少，淋巴细胞比率降低，中性粒细胞数正常（6．04％）。③病程第1周内出现白细胞及中性粒细胞减少的占77．64％。白细胞总数减少者75．83％在1周内恢复，而中性粒细胞减少者一周内恢复者仅占59．52％。（垒）伴发疾病中呼吸道疾病占82．18%，幼儿急疹次之占5．44％。⑤病原体以病毒为主，其次为肺炎支原体。结论①男性婴幼儿、学龄前期患儿为高发人群。②病毒感染引起的呼吸道疾病多发。③白细胞及中性粒细胞减少类型与淋巴细胞有很大关系，外周血淋巴细胞比率增高可能是一种保护性的细胞免疫反应。

Study on analysis of related factors of leukocytopenia and neutropenia in 33l childish patients

Objective To investigate the clinical features and related factors of leukocytopenia and neutropenia and to provide clinical basis for diagnosis and treatment of leukocytopenia and neutropenia. Methods The clinical data of 331 patients with leukocytopenia and neutropenia admitted during January 2002 to December 2008, and clinical manifestations, correlated laboratory examinations, treatment as well as therapeutic effects were retrospectively reviewed and analyzed. Results ①The percentage of infants and preschool children in this series was 83.69%, the ratio of male to female was 1.88 to 1. ②There were four types of leukopenia and neutropenia： a. The amount of leucocytes and neutrophils was reduced at the same time（54.68% ）. b. The total number of leukocytes was normal, but when the ratio of lymphocytes 〉75%, the counts of neutrophils decreased （ 25.98 % ）. c. The total number of leukocytes was reduced, but when the differentiation of leucocytes was normal, the count of neutrophils could be reduced or normal（ 13.29% ）. d. The total number of leukocytes and the ratio of lymphocytes was reduced at the same time, and the count of neutrophils could be normal（6.04% ）. ③The percentage of leukocytopenia and neutropenia within one week of the course was 77.64%. The percentage of leukocytopenia recovered within one week was 75.83%, while the neutropenia recovered was 59.52% within one week.④Among their complicated diseases, 82.18 % of them were respiratory infections, and secondly they were suffered with exanthema subitum. ⑤The causal agents were mainly virus and mycoplasma pneumoniae. Conclusion ①The highest incidence rate with leukocytopenia and neutropenia was occurred in male infants and preschool children.②Respiratory disease caused by virus was the most common reason leading to leukocytopenia and ncutrupenia. ③The type of leukocytopenia and neutropenia is linked to lymphocytes, and the increase of proportion of lymphocytes in peripheral blood may be a protective cellular immune response.