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目的 探讨特发性血小板减少性紫癜 (ITP)与人细小病毒B19感染性的关系。方法 采用巢式聚合酶链反应技术分别对 6 3例ITP患儿的血清、38例ITP患儿的骨髓液检测人细小病毒B19 DNA。并与对照组进行对比。结果 ① 6 3例ITP静脉血中人细小病毒B19 DNA阳性 12例 ,阳性率为 19 1% ,186例健康儿童 11例阳性 ,阳性率为 5 91%。血清的ITP组与对照组差异有显著意义 (χ2 =9 6 8,P <0 0 1)。② 38例ITP患儿的骨髓液中人细小病毒B19 DNA 16例阳性 ,阳性率为 4 2 1% ,对照组 30例阳性 3例 ,阳性率为10 % ,骨髓ITP组与对照组差异有显著意义 (χ2 =8 5 8,P <0 0 1)。③血清的ITP组 12例阳性病例中 ,11例是急性ITP ,阳性率为 2 3 4 % ;1例是慢性ITP ,阳性率为 5 9% ,差异有显著意义 (χ2 =3 0 9,P <0 0 5 )。骨髓的ITP组急性 2 9例 ,阳性 15例 ,阳性率为 5 1 7% ;慢性 9例 ,阳性 1例 ,阳性率为 11 1%。ITP组与对照组差异有显著意义 (χ2 =4 6 5 ,P <0 0 5 )。男女之间无差异。结论 ①ITP人群有较高的B19感染率 ,一部分ITP病儿与人细小病毒B19感染密切相关。②临床上一部分ITP患儿的发病可能为人细小病毒B19感染所导致。③B19感染相关性ITP以急性ITP为主。
Objective To investigate the relationship between idiopathic thrombocytopenic purpura (ITP) and human parvovirus B19 infectivity. Methods Using nested polymerase chain reaction to detect human parvovirus B19 DNA in serum of 63 children with ITP and bone marrow of 38 children with ITP respectively. And compared with the control group. Results ① The positive rate of B19 DNA in 13 6 cases of ITP venous blood was 19.1%, 11 of 186 healthy children were positive, the positive rate was 5 91%. There was significant difference between serum ITP group and control group (χ2 = 9 6 8, P <0.01). ② The positive rate of B19 DNA in bone marrow fluid of 38 children with ITP was 42.1%, the positive rate was 10% in the 30 cases of the control group, and the difference was significant between the ITP group and the control group Significance (χ2 = 8 5 8, P <0 0 1). ③ Serum ITP group 12 cases of positive cases, 11 cases of acute ITP, the positive rate was 23.4%; 1 case of chronic ITP, the positive rate was 59%, the difference was significant (χ2 = 3009, P <0 0 5). In the bone marrow ITP group, 29 were acute and 15 were positive, the positive rate was 51.7%. Chronic 9 cases were positive and 1 was positive. The positive rate was 11.1%. There was significant difference between ITP group and control group (χ2 = 465, P <0 05). No difference between men and women. Conclusion ①ITP population has a higher infection rate of B19, and some ITP sick children are closely related to human parvovirus B19 infection. ② The clinical incidence of some ITP children may be caused by human parvovirus B19 infection. ③ B19 infection-related ITP mainly acute ITP.