43例婴儿急性特发性血小板减少性紫癜的临床特点及治疗方案探讨

THERAPY AND CHARACTERISTIC CONCERNING ACUTE IDIOPATHIC THROMBOCYTOPENIC PURPURA IN INFANTS: A REPORT OF 43 CASES

目的探讨婴儿急性特发性血小板减少性紫癜(ITP)的临床特点,对比3种治疗方案的疗效,寻找最佳的治疗方案。方法总结2001年1月—2005年8月婴儿ITP43例的临床特点,其中重度以上31例分别应用丙种球蛋白(丙球组11例)、丙种球蛋白+激素(丙球+激素组10例)、激素(激素组10例)治疗,比较治疗后血小板恢复情况。结果婴儿ITP以重度、极重度多见,出血部位单纯,以皮肤出血点、淤点、淤斑为主;丙球组,丙球+激素组治疗后血小板变化相似,差异无统计学意义,激素组治疗后血小板数较低,差异有统计学意义。结论婴儿期ITP以皮肤粘膜出血为主,自然病程短,对严重病例特别并发内脏感染者可首选丙球治疗。

Objective To discuss the characteristics of acute idiopathic thrombocytopenic purpura （ITP） in infants and compare the effects of 3 therapies for searching simple and furthest project. Methods 43 infants with ITP from January of 2001 to August of 2005 were analyzed. The 3 therapies were applied to 31 cases with serious PLT drop. The 3 therapies were as follows：the large dose of immunity globin （globin group, 11 cases）, the large dose of immunity globin plus hormone（globin plus hormone group, 10 cases）,the hormone（hormone group, 10 cases）. The value of PLT was compared after treatment. Results Serious ITP was common in infant ITP. Bleeding place was limited, inside bleeding was little. The curative effect was sameness in globin group and globin plus hormone group. The hormone group was significantly low and slow on the PLT value going up and the number of days concerning PLT achieving 100 × 10^9/L. Conclusion Skin bleeding occurs commonly in ITP infants, nature course of ITP disease is short. The serious ITP infants with inside bleeding and infection are treated primarily with immunity globin in order to avoid side-effects of hormone.