小儿原发性血小板减少性紫癜的发病因素及相关检查

Pathogen and related tests on children′s idiopathic thrombocytopenic purpura

目的:探讨小儿原发性血小板减少性紫癜(ITP)的发病因素及相关检查意义。方法:选择原发性血小板减少性紫癜患儿60例,采用ELISA法进行呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感(IV)、副流感病毒(PIV)、巨细胞病毒(CMV)、EB病毒(EBV)、支原体(MP)及幽门螺杆菌(HP)抗体的检测。按血小板计数将患儿分为3组:血小板<20×109/L组29例,(20～50)×109/L组20例,>50×109/L组11例,测定3组患儿治疗前后血小板聚集功能及网织血小板百分率(RP%)、绝对值(RPs)的变化。结果:生物感染的发病率依次为RSV35.0%、ADV23.3%、MP16.7%、CMV13.3%、EBV10.0%、HP10.0%、IV5.0%、PIV3.3%;血小板<20×109/L组及(20～50)×109/L组治疗前后血小板聚集功能及网织血小板百分率、绝对值比较差异均有统计学意义(P<0.01～0.05),>50×109/L组治疗前后比较差异均无统计学意义(P>0.05);组间两两比较,治疗前<20×109/L组、(20～50)×109/L组与>50×109/L组相比血小板聚集功能及网织血小板百分率、绝对值差异有统计学意义(P<0.05),<20×109/L组与(20～50)×109/L组相比差异均无统计学意义(P>0.05);治疗后3组相比差异均无统计学意义(P>0.05)。结论:原发性血小板减少性紫癜的发病与生物感染有关,其临床表现与血小板聚集功能及网织血小板百分率、绝对值的变化有关。

Objective： To investigat pathogen and significance of related tests on children＇s idiopathic thrombocytopenic purpura. Methods. RSV-antibody, ADV-antibody, IV-antibody, PIV-antibody, CMV-antibody, EB- antibody, MP-antibody, HP-antibody were tested by ELISA. A total of 60 patients with idiopathic thrombocytopenic purpura were divided into three groups according to their platelets count; To test aggregative function of platelets, the percent and absolute counts of reticulated platelets （RPs） in the period of onset and recovery. Results. Infection rate were 35. 0% （RSV）, 23. 3% （ADV）, 16,7% （MP）, 13.3%（CMV）, 10.0%（EB）, 10.0%（HP）, 5.0% （influenza virus, IV）, 3.3% （parainfluenza virus, PIV）, respectively, the difference was significant between G20）〈 109 group and （20-50） ×10^9/L group in the period of onset and recovery in aggregative function, RP% and RPs （P〈0.01-〈0.05）. The difference was significant in 〉50× 10^9/L group （P〉0.05） . To compare between groups, the difference was significant between〈G20× 10^9/L group and 〉50×10^9/L group before treatment （P 〈0.05）, so did （20- 50） × 10^9/L group and 〉50 × 10^9/L group （P 〈0.05）. There were not significant differences among three groups after treatment （P 〉0.05）. Conclusion. Idiopathic thrombocytopenic purpura are associated with virus infection, clinical manifestation are associated with the variety of aggregative function of platelets, RP% and RPs.