婴幼儿特发性血小板减少性紫癜401例临床特点

目的 分析婴幼儿特发性血小板减少性紫癜(ITP)的临床特点,并比较婴儿与幼儿ITP的疗效.方法 收集401例婴幼儿ITP,均给予激素冲击治疗和静脉滴注免疫球蛋白治疗,疗效判定依据血小板计数的高低和出血症状的改善分为完全缓解、有效、无效.401例婴幼儿ITP按年龄分为婴儿组(≤1岁)和幼儿组(>1～3岁),按病程分为急性(病程≤6个月)和慢性(病程>6个月),对其临床资料进行回顾性分析,应用SPSS 12.0软件进行统计分析.结果 1.婴儿组与幼儿组均为男童比例高,但2组间性别比较差异无统计学意义(χ2=0.682,P>0.05).2.婴儿组入院时血小板中位计数低于幼儿组,差异有统计学意义(Z=2.668,P<0.05).3.婴儿组骨髓巨核细胞增高比例低于幼儿组,差异有统计学意义(χ2=16.322,P<0.001);婴儿组产板巨核细胞中位数低于幼儿组,差异有统计学意义(Z=2.065,P<0.05).4.婴儿组经治疗后血小板计数达到或超过100×109 L-1的时间短于幼儿组,差异有统计学意义(Z=3.542,P<0.001).5.急性患儿入院时血小板中位计数低于慢性患儿,差异有统计学意义(Z=2.100,P<0.05).6.输注血小板患儿的住院时间与未输注血小板患儿相比,差异无统计学意义(Z=1.385,P>0.05).结论 婴幼儿ITP中,男童比例高,大部分无明显诱因,以皮肤黏膜出血为主;婴儿入院时血小板中位计数较低,血小板上升至正常的时间较短,对治疗反应较幼儿好,幼儿急性ITP可以变为慢性;输注血小板并不能缩短ITP患儿的住院时间.

Clinical Characteristics of Idiopathic Thrombocytopenic Purpura in 401 Infants

Objective To analyze clinical characteristics of infants with idiopathic thrombocytopenic purpura(ITP) from 1 month to 3 years old,and compare the therapeutic effects.Methods The data of 401 ITP children were collected.All of the patients were given hormone shock treatment and intravenous immunoglobulin.According to the extent of platelet count and bleeding improvement,the outcome included:complete remission,effective,invalid.The patients were divided into younger group(≤1 year old) and older group(>1-3 years old)based on age,acute group(≤6 months) and chronic group(>6 months)based on the course of disease,their clinical data were retrospectively analyzed by SPSS 12.0 software.Results 1.Although both the younger group and the older group had higher male/female ratio,there was no significant difference of the percentage of the male between younger group and older group(χ2=0.682,P>0.05).2.The median of platelet count at admission in the younger group were statistically lower than those in the older group(Z=2.668,P<0.05).3.Both the median of megakrocytes(which produce platelets) and the increase ratio of megakrocytes in the younger group were statistically lower than that in the older group(Z=2.065,P<0.05;χ2=16.322,P<0.001).4.Under the same treatment,the time needed for the platelets to become normal(≥100×109 L-1) in the younger group were statistically lower than that in the older group(Z=3.542,P<0.001).5.The median of platelet count at admission in the acute group were statistically lower than that in the chronic group(Z=2.100,P<0.05).6.There was no significant difference in terms of hospital stays between the transfused patients and untransfused patients(Z=1.385,P>0.05).Conclusions The infants with ITP have higher male/female ratio,most possess unobvious incentive and mucocutaneous hemorrhage.The younger patients(≤1 year old) with lower platelet count at admission,faster platelet count recovery to normal,and better treatment efficacy.The elder patients can become chronic ITP.The hospital stays can not be shortened in the patients with ITP who were transfused with platelets.