160例儿童免疫性血小板减少症预后影响因素的分析

Analysis of prognostic factors of 160 children with immune thrombocytopenia

目的探讨儿童免疫性血小板减少症(Idiopathic thrombocytopenic purpura,ITP)的临床特点及影响预后的因素,为临床判断患儿预后及治疗提供依据。方法回顾性分析新疆医科大学第一附属医院2017年12月-2019年12月收治的160例ITP患儿的临床资料,统计分析可能影响儿童ITP预后的相关因素,通过单因素、多因素回归分析得出影响预后的独立影响因素。结果本研究共收集病例160例,单因素分析显示性别、首次就诊出血方式、病原体感染情况与缓解率无关,而初诊血小板计数、25-(OH)D3、C3、IgG与缓解率有关。运用Logistic多因素分析法,结果显示儿童ITP的显著影响因素为初诊血小板计数,其次为IgG。以3~12个月获得缓解为状态变量,初诊时IgG水平为检验变量,绘制ROC曲线,初始IgG达26.27g/L时,显示出ROC曲线下面积最大,为0.75,敏感性为50.00%,特异性为91.50%。结论在儿童ITP中初诊血小板计数、诱因、25-(OH)D3、C3、IgG与缓解率有关,对于ITP患儿预后判断具有积极作用。

Objective To investigate the clinical characteristics and prognostic factors of children with Idiopathic thrombocytopenic purpura(ITP),so as to provide a basis for clinical judgment of the prognosis and treatment of children.Methods The clinical data of 160 children with ITP admitted to the first affiliated hospital of Xinjiang Medical University from December 2017 to December 2019 were retrospectively analyzed,and the related factors that might affect the prognosis of children with ITP were statistically analyzed.Univariate and multivariate regression analysis was performed.The independent influencing factors of prognosis were obtained.Results A total of 160 cases were collected in this study.Univariate analysis showed that gender,bleeding pattern at the first visit,and pathogen infection were not associated with the remission rate,while platelet count,25-(OH)D3,C3,and IgG at the first visit were associated with the remission rate.Logistic multivariate analysis showed that the significant influencing factor of ITP in children was newly diagnosed platelet count,followed by IgG.Using 3-12 months of remission as the state variable,and initial IgG level as the test variable,an ROC curve was drawn.When the initial IgG level was 26.27 g/L,the area under the ROC curve was maximized at 0.75,with sensitivity of 50.00%and specificity of 91.50%.Conclusion In children with ITP,the newly diagnosed platelet count,inducement,25-(OH)D3,C3,and IgG are related to the remission rate,and have a positive effect on the prognosis of children with ITP.