儿童慢性特发性血小板减少性紫癜472例临床分析

目的阐述中国儿童慢性特发性血小板减少性紫癜（CITP）发病规律及治疗反应等一系列特点，有助于国内和国际有关儿童CITP的研究。方法回顾性分析钾2例慢性ITP儿童的临床资料，系统评价其疾病自然史以及治疗的反应等。结果472例惠儿主要的出血表现为紫癜（430例，91．1％），有2例惠儿（男女各一）发生颅内出血。324例接受了一线治疗，有效率为58．9％；一线治疗以激素治疗疗效最为显著。216例接受了二线治疗，在二线治疗中，以脾切除术最为有效，其次为激素治疗。结论对于儿童慢性ITP来讲，脾切除为有效率最高的手段，激素治疗在一线和二线治疗中都可以作为有效的选择。传统中医药治疗儿童慢性ITP并未显现出优势。

Clinical analysis of 472 cases of chronic idiopathic thrombocytopenic purpura

Objective To demonstrate the pathogenesis and treatment responses in Chinese children with chronic idiopathic thrombocytopenic purpura(CITP) which will benefit the research of domestic and international children CITP.Methods Clinical data of 472 CITP cases were retrospectively analyzed.The history and the therapy response of CITP were assessed systematically.Results The main bleeding feature of 472 CITP children was purpura in 430 cases(91.1%),2 of whom experienced intracerebral bleeding(a boy and a girl).The first-line therapy effective rate was 58.9% in 324 cases,in which hormone had the most significant therapeutic effect.216 cases received the second-line therapy,of which splenectomy was the most effective and the following was hormone therapy.Conclusion Splenectomy is the most effective method to treat children CITP.Hormone therapy can be an effective choice in the first-line and second-line therapy.Traditional Chinese medicine does not show better effects on CITP as hormone.