HCMV感染在小儿特发性ITP中的作用及机制

目的：探讨小儿血小板减少性紫癜（ITP）与巨细胞病毒（HCMV）感染的相关性。方法：选取52例ITP患儿为研究对象，根据临床分度将其分为急性型（AITP）21例以及慢性型（CITP）31例，同时选取g0例健康体检儿童为对照组，采用二步免疫组化法测定各组骨髓中HCMV—IgM及采用ELISA免疫法测定各组血清中HCMV—IgM，并对各组临床特点进行分析。结果：AITP组及CITP组骨髓中HCMV阳性率显著血液中HCMV阳性率，差异有统计学意义（P〈0.05）；CITP骨髓及血液＋HC—MV阳性率均高于AITP及对照组，差异有统计学意义（P〈0．05）；AITP及cITP组中骨髓HCMV（＋）者平均年龄、IL-6、TNF—a水平均高于骨髓HCMV（-）者，而血小板计数少于HCMV（-），差异有统计学意义（P〈0．05）；而CITP组中骨髓HCMV（＋）者IL-6、TNF—a水平高于AITP组HCMV（-）者，而血小板计数少于AITP组HCMV（-）者，差异有统计学意义（P〈0．05）；AITP及CITP组中血液HCMV（＋）者平均年龄、血小板计数、IL-6、TNF—a水平均与血液HCMV（-）者相比，差异无统计学意义（P〉0．05）。结论：骨髓HCMV感染可能是引起ITP发病的重要因素之一。骨髓HCMV感染可能是引起ITP患儿病情加重及慢性化趋向的重要因素，骨髓HCMV感染在ITP患儿发病机制中可能通过破坏患儿免疫系统从而影响血小板的生成，并不是抑制红细胞的生成。

Role and mechanism of HCMV infection in children with idiopathic ITP

Objective： To investigate the correlation between ediatric thrombocytopenic purpura （ITP） and cytomegalovirus （HCMV） infection. Methods： A total of 52 ITP patients were divided into a- cute type （AITP）（n=21）and chronic type （CITP） （n=31）, besides 30 cases of healthy children were also selects as control group. The bone marrow HCMV-IgM and serum HCMV-IgM were measured with two- step immunohistochemical method and ELISA immunoassay method. The clinical characteristics of each group were also analyzed. Results： In both AITP group and CITP group, positive rate of marrow HCMV rates were higher than the serum HCMV-positive rate （P〈i0.05）. Both marrow and serum HCMV-posi- tire rate of the AITP group were higher than that of the control group （P〈0.05）. In both AITP and CITP groups, marrow HCMV （＋） patients showed older average age, and higher IL-6 and TNF-a levels, while less platelet counts than bone marrow HCMV （--） patients （P〈0.05）. Marrow HCMV （＋） pa- tients in the CITP group showed higher IL-6 and TNF-a levels and less platelet counts than HCMV （-） patients in the AITP group （P%0.05）. No significant difference in average age, IL-6 and TNF-a levels or platelet counts were found between the serum HCMV （＋） patients in AITP group and CITP group. Con- clusion. Bone marrow HCMV infection may be one cause of ITP. Bone marrow HCMV infection may ag- gravate children ITP and make it tend to be chronic, probably by affecting immune system to damage for- mation of platelets.