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目的探讨影响小儿急性特发性血小板减少性紫癜(AITP)发展成慢性特发性血小板减少性紫癜(CITP)的危险因素。方法选择2006年5月至2010年4月于广西医科大学一附院诊断AITP住院患儿138例,对患儿临床表现、实验室检查、治疗方案等16个相关因素分别进行单因素成组对照研究。对有意义的单因素,再运用非条件Logistic多因素回归模型分析,以期找到有意义的因素。结果病程(患儿起病至治疗时间)、ORh(D)+型血、用含有大剂量丙种球蛋白的治疗方案、血小板上升正常时间都是影响AITP患儿转为慢性的主要因素,而与发病年龄、治疗初用血小板、血小板开始回升时间、性别、有无前驱显性感染、治疗前血小板数、血小板平均体积、血小板平均分布系数、骨髓巨核细胞数、幼稚巨核细胞数、颗粒型巨核细胞数、有无幼稚淋巴细胞数无关。结论 AITP患儿早期治疗时用有大剂量丙种球蛋白的治疗方案是改善预后的关键,治疗时血小板回升正常时间晚、ORh(D)+血型(相对于A和B血型)是转为慢性的高危因素。
Objective To explore the risk factors that affect the development of acute idiopathic thrombocytopenic purpura (AITP) in children with chronic idiopathic thrombocytopenic purpura (CITP). Methods From May 2006 to April 2010, 138 cases of AITP inpatients were diagnosed in First Affiliated Hospital of Guangxi Medical University, and 16 related factors such as clinical manifestations, laboratory tests and treatment regimens in children were analyzed by single factor grouping the study. The single factor of significance, and then use non-conditional Logistic regression model analysis, in order to find meaningful factors. Results The course of disease (onset of disease from onset to treatment), ORh (D) + type of blood, treatment with high-dose gamma globulin, and normal platelet uptake were all major factors that affected AITP children to become chronic, Age of onset, platelet count at the beginning of treatment, time to platelet initiation, gender, presence or absence of dominant dominant infection, platelet count before treatment, mean platelet volume, average platelet distribution coefficient, number of megakaryocytes, naive megakaryocyte, The number of naive lymphocytes has nothing to do. Conclusions The treatment of AITP in children with early treatment with high-dose gamma-globulin is the key to improving prognosis. The platelet reversion is normal after treatment, and ORh (D) + blood type (compared with A and B blood types) is converted to chronic High risk factors.