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目的分析儿童特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)的临床表现及治疗情况,比较急、慢性ITP的不同点。方法对安徽医科大学第一附属医院2008年1月~2010年12月期间,住院的202例ITP病例临床资料进行回顾性分析。结果 202例ITP患儿,男106例(52.48%),女96例(47.52%),急性ITP 177例(87.62%),慢性、难治性ITP 25例(12.38%),6岁及以下患儿156例(77.23%),6岁以上46例(22.77%);有174例(86.14%)ITP患儿发病时血小板呈重度、极重度减少,但临床多为轻度出血(81.68%);急性组单用激素治疗有效率89.66%,单用丙种球蛋白治疗有效率73.33%,两者联合治疗有效率为88.98%;慢性、难治性ITP激素联合丙种球蛋白治疗有效率54.55%。结论儿童ITP多见于6岁及以下,男女发病机会均等,该病临床发病急而症状轻。对急性ITP应用激素和(或)丙种球蛋白治疗可取得较好的疗效。
Objective To analyze the clinical manifestations and treatment of idiopathic thrombocytopenic purpura (ITP) in children and to compare the differences between acute and chronic ITP. Methods The clinical data of 202 cases of ITP admitted in the First Affiliated Hospital of Anhui Medical University from January 2008 to December 2010 were retrospectively analyzed. Results 202 children with ITP had 106 cases (52.48%) of males and 96 cases (47.52%) of females, 177 cases of acute ITP (87.62%), 25 cases of chronic and refractory ITP 156 cases (77.23%) were infants and 46 cases (22.77%) were over 6 years old. 174 cases (86.14%) had severe and extremely severe platelet death at onset, In acute group, the effective rate of hormone therapy alone was 89.66%, that of gamma globulin alone therapy was 73.33%, the effective rate of combined therapy was 88.98%, and that of chronic and refractory ITP hormone combined with gamma globulin was 54.55%. Conclusion Children ITP more common in children aged 6 and below, equal opportunities for men and women, the clinical onset of acute and mild symptoms. Acute ITP application of hormones and (or) gamma globulin treatment can achieve better results.