小儿B19病毒感染相关性重症血液病51例

Severe blood diseases associated with human parvovirus B19infection in51children

目的探讨B19病毒感染相关性小儿重症血液病的临床特征与治疗。方法回顾性总结51例小儿B19病毒感染相关性重症血液病的临床资料 ,分析其治疗与预后。结果检测B19抗原或抗体阳性加B19DNA阳性 ,确定为B19病毒感染的重症血液病患儿51例中 ,急性血小板减少性紫癜32例 ,急性再生障碍性贫血9例 (包括纯红细胞再生障碍性贫血3例 ) ,急性白血病合并重度贫血6例 ,溶血性贫血并发急性再障危象3例 ,噬血细胞综合征1例 ;所有患儿均重度或极重度血细胞减少 ,38例合并内脏出血 ,12例合并细菌或真菌感染。经应用大剂量丙种球蛋白 ,同时加强对症治疗与支持疗法、防治严重并发症 ,结果好转和治愈48例 (94.12 % ) ,死亡3例 (5.88 % )。结论B19病毒感染相关性小儿重症血液病应加强抗病毒及止血的治疗。

Objective To explore the clinical feature and treatment in51children with severe blood diseases associated with human parvovirus B19infection.Methods Clinical data of51children with severe blood diseases caused by human parvovirus B19infection were reviewed and the treatment and prognosis were analyzed.Results Of the51children with severe blood diseases caused by human parvovirus B19in fection who were positive for B19antigen or both B19antibody and B19_DNA,32cases were diagnosed as acute idiopathic thrombocytopenia purpura,6as acute aplastic anemia,6as acute leukemia combined with severe anemia,3as hemolytic anemia combined with aplastic anemia crisis,3as pure red cell aplastic anemia and1as hemophagocytic syndrome,respectively.All patient had severe cytopenia,and of which,38cases were combined with visceral hemorrhage and12cases combined with bacterial or fungal infection.With the combined use of high dose intravenous immunoglobin with allopathy and supporting measures,48cases(94.12%)were cured or improved,and3cases(5.88%)were death.Conclusions It should be reinforced to use antiviral and homeostatic therapy for children with severe blood diseases associated with human parˉvovirus B19infection.