婴儿巨核细胞减少型特发性血小板减少性紫癜的特点

Clinical characteristics of idiopathic thrombocytopenic purpura with megalocaryocyte in infants

目的:探讨婴儿巨核细胞减少型特发性血小板减少性紫癜(ITP)的发病机制、诊治效果与特点。方法:对55例血小板减少婴儿进行血常规、病毒抗体、血小板抗体及骨髓细胞形态学等相关检查,确诊特发性血小板减少性紫癜,39例给予抗感染+丙种球蛋白+激素治疗,16例仅给予抗感染治疗。结果:病初有感染史30例,病毒抗体阳性14例,支原体(MP)抗体和衣原体抗体阳性共4例,血小板抗体阳性1例,骨髓19例可见原始和幼稚粒细胞增多,14例见原始和幼稚淋巴细胞增多,39例巨核细胞数减少,15例巨核细胞数正常,1例巨核细胞数增多。经丙种球蛋白与激素治愈38例,1例血小板抗体阳性伴巨核细胞数增多者转化为慢性ITP,16例仅给予抗感染治疗患儿全部治愈。结论:婴儿ITP特点是绝大多数可能与直接感染特别是病毒感染有关,血小板抗体阴性,不存在自身免疫紊乱,多数患儿骨髓中幼稚细胞增多,巨核细胞减少,控制感染后血小板逐渐恢复正常。

Objective： To interprete the mechanism, clinical effects and characteristics ot idiopathic thrombocytopenic purpura with megalocaryocyte in infant. Methods： Fifty - five infants were diagnosed as ITP through examining blood routine, viral antibody and bone marrow morphology, thirty-nine infants were treated with anti -infection, immunoglobulin and hormone, and 16 cases were treated only with anti -infection. Results： Thirty cases were with prehistoric infection, 14 infants were with positive viral antibody, 4 cases were with mycoplasm pneumonia and chlamydia pneumonia, 19 cases were with primitive or childish increased granule cell, 14 cases with primi- tive and childish lymphocyte, 39 cases were with megalocaryocyte, 15 cases were with normal megalocaryocyte cell, 1 case was with mega- locaryocyte, 38 cases were cured by immunoglobulin and hormone, aLl of the 16 children were cured , who treated only with anti - infection. Conclusion： Majority of ITP in infants are directly related with infection, especially with viral infection, the patients are with negative anti -platelet antibody, without abnormal autoimmune, increased childish cell and megalcytopenia, platelet is restored following infection controlled.