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目的探讨疫苗相关性血小板减少性紫癜的临床特点及预后。方法收集我院2007年1月～2010年1月住院治疗的特发性血小板减少性紫癜患儿100例,其中疫苗相关性血小板减少性紫癜患儿21例为观察对象。结果 21例患儿中男/女=1.63,中位年龄为11个月;除麻疹、乙肝、水痘等疫苗可引起血小板减少性紫癜外,观察到口服轮状病毒疫苗亦可引起血小板减少性紫癜;临床表现以皮肤粘膜出血为主,脏器出血患儿少见;治疗主要以丙种球蛋白联合激素治疗为主,90.48%患儿可在2～4周内恢复正常,9.52%患儿病情反复。结论疫苗相关性血小板减少性紫癜多数急性起病,男性患儿占62%,预后良好;疫苗与血小板减少性紫癜因果关系不能肯定,尚需进一步研究;丙种球蛋白联合激素治疗效果显著,短期复发危险低;加强疫苗接种后检测,降低疫苗接种不良反应的发生。
Objective To investigate the clinical characteristics and prognosis of vaccine-associated thrombocytopenic purpura. Methods 100 cases of idiopathic thrombocytopenic purpura hospitalized in our hospital from January 2007 to January 2010 were collected, among which 21 cases of vaccine-associated thrombocytopenic purpura were observed. Results Among the 21 cases, the male / female was 1.63 with a median age of 11 months. Besides measles, hepatitis B and chickenpox could cause thrombocytopenic purpura, it was observed that oral rotavirus vaccine could also cause thrombocytopenic purpura The main clinical manifestations were skin and mucous membrane bleeding and rare bleeding in children. Treatment mainly consisted of gamma globulin combined with hormone therapy. 90.48% of the children returned to normal within 2 to 4 weeks, and 9.52% of children suffered from repeated illness. Conclusion Vaccine-associated thrombocytopenic purpura most acute onset, male patients accounted for 62%, the prognosis is good; Vaccine and thrombocytopenic purpura causal relationship can not be affirmed, still need further study; gamma globulin combined with hormone therapy is significant, short-term recurrence Low risk; strengthen post-vaccination testing to reduce the incidence of adverse reactions to vaccination.