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目的分析婴幼儿特发性血小板减少性紫癜(ITP)的临床特点,并比较婴儿与幼儿ITP的疗效。方法收集401例婴幼儿ITP,均给予激素冲击治疗和静脉滴注免疫球蛋白治疗,疗效判定依据血小板计数的高低和出血症状的改善分为完全缓解、有效、无效。401例婴幼儿ITP按年龄分为婴儿组(≤1岁)和幼儿组(>1~3岁),按病程分为急性(病程≤6个月)和慢性(病程>6个月),对其临床资料进行回顾性分析,应用SPSS 12.0软件进行统计分析。结果 1.婴儿组与幼儿组均为男童比例高,但2组间性别比较差异无统计学意义(χ2=0.682,P>0.05)。2.婴儿组入院时血小板中位计数低于幼儿组,差异有统计学意义(Z=2.668,P<0.05)。3.婴儿组骨髓巨核细胞增高比例低于幼儿组,差异有统计学意义(χ2=16.322,P<0.001);婴儿组产板巨核细胞中位数低于幼儿组,差异有统计学意义(Z=2.065,P<0.05)。4.婴儿组经治疗后血小板计数达到或超过100×109L-1的时间短于幼儿组,差异有统计学意义(Z=3.542,P<0.001)。5.急性患儿入院时血小板中位计数低于慢性患儿,差异有统计学意义(Z=2.100,P<0.05)。6.输注血小板患儿的住院时间与未输注血小板患儿相比,差异无统计学意义(Z=1.385,P>0.05)。结论婴幼儿ITP中,男童比例高,大部分无明显诱因,以皮肤黏膜出血为主;婴儿入院时血小板中位计数较低,血小板上升至正常的时间较短,对治疗反应较幼儿好,幼儿急性ITP可以变为慢性;输注血小板并不能缩短ITP患儿的住院时间。
Objective To analyze the clinical features of idiopathic thrombocytopenic purpura (ITP) in infants and young children and compare the efficacy of ITP in infants and young children. Methods 401 cases of infants and young children were collected ITP, were given hormone therapy and intravenous immunoglobulin therapy, efficacy evaluation based on the level of platelet count and improvement of bleeding symptoms were divided into complete remission, effective and ineffective. 401 infants and young children were divided into infants (≤1 years) and young infants (> 1-3 years) according to their ages. According to their duration of illness, ITP was divided into acute (duration ≤6 months) and chronic (duration> 6 months) The clinical data were retrospectively analyzed, and SPSS 12.0 software was used for statistical analysis. Results 1. There was a high proportion of boys in both infants and toddlers, but there was no significant difference in sex between the two groups (χ2 = 0.682, P> 0.05). The infants’ admission median platelet count was lower than that of the young children group, the difference was statistically significant (Z = 2.668, P <0.05). The ratio of bone marrow megakaryocytes in infant group was lower than that of young children group (χ2 = 16.322, P <0.001). The median of plate megakaryocyte in infant group was lower than that of young children group (P <0.001), and the difference was statistically significant = 2.065, P <0.05). 4. Infant group after treatment platelet count reached or exceeded 100 × 109L-1 time shorter than the infant group, the difference was statistically significant (Z = 3.542, P <0.001). 5. The median platelet count of children with acute admission was lower than that of chronic children at admission, the difference was statistically significant (Z = 2.100, P <0.05). The hospitalization time of infants with platelet transfusion was not significantly different from that of infants without transfusion of platelet (Z = 1.385, P> 0.05). Conclusions Infants and young children have a high proportion of boys in the ITP group, most of whom have no obvious predisposition, with mucocutaneous bleeding predominating. When infants are admitted to hospital, the median platelet count is low, the platelet up to normal time is short, and the response to treatment is better than that of young children. Acute ITP in infants can become chronic; infusion of platelets does not reduce hospital stays in children with ITP.