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本文对我院近10年中24例小儿自身免疫性溶血性贫血(AIHA)进行了临床分析,提示小儿起病年龄多在5岁以内,新生儿并不少见。临床表现主要是急性溶血和严重贫血,严重者可导致心衰而死亡。病程多呈自限性痊愈。预后与合并的潜在疾病有关,由于小儿恶性及慢性疾病较成人为少,故预后较好,但小儿合并原发性血小板减少性紫癜者易转为慢性,或应用激素过程中并发感染而死亡。诊断依据为抗人球蛋白试验阳性。多数认为AIHA与机体免疫功能紊乱有关,故治疗是兼顾或调整细胞免疫和体液免疫的不平衡;对Evan’s综合症则以切脾较好。
This article in our hospital nearly 10 years in 24 cases of pediatric autoimmune hemolytic anemia (AIHA) were analyzed, suggesting that pediatric onset age more than 5 years old, the newborn is not uncommon. Clinical manifestations are mainly acute hemolysis and severe anemia, severe heart failure can lead to death. Mostly self-limited course of recovery. Prognosis and the potential for the merger of the disease, as children with malignant and chronic diseases less than adults, so the prognosis is good, but children with primary thrombocytopenic purpura tend to switch to chronic, or the application of hormonal process of infection and death. Diagnosis is based on anti-human globulin test positive. Most believe that AIHA and the body immune dysfunction, so the treatment is to balance or adjust the imbalance between cellular immunity and humoral immunity; Evan’s syndrome is better splenectomy.