儿童特发性血小板减少性紫癜研究进展被引量：22

Advancement of Idiopathic Thrombocytopenic Purpura in Children

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摘要儿童特发性血小板减少性紫癜（ITP）虽是一种常见疾病,但诊断和治疗仍有很多未能解决的问题。儿童发病有其特点起病急、自限性居多;男童发病率偏高;以严重血小板减少为主,而少见威胁生命的严重出血;临床过程大多平静,多数6个月内恢复,未恢复的患儿仍有一定自行恢复可能,因此被定义为仅有血小板减少、而其他方面健康的儿童身上发生的疾病状态。在发病机制方面已由过去简单认为血小板特异抗体吸附引起单核-巨噬系统吞噬造成血小板减少衍变到对机体免疫尤其是细胞免疫异常的认识,个体的遗传易感性也成为关注的焦点。被称为“免疫捕捉法”的血小板抗体检测方法逐步替代特异性差的血小板抗体检测法,血小板功能和幽门螺杆菌的监测及意义尚需探讨。对血小板（20-30）×10^9/L且无明显出血的患儿,观察和等待是最佳方法,而需要治疗时丙种球蛋白和糖皮质激素是一线治疗方法。目前新的治疗方法有大剂量地塞米松、抗CD20、血小板生成素（TPO）类似物等。由于远期效果不肯定、手术并发症及感染暴发,儿科医师对于脾切除越来越持谨慎态度。ITP患儿的社会心理情况也引起了人们重视。相信随着科学发展,儿童ITP的相关问题会逐步得到解决。

作者吴润晖

机构地区首都医科大学附属北京儿童医院血液病中心

出处《实用儿科临床杂志》 CAS CSCD 北大核心 2007年第3期161-164,共4页 Journal of Applied Clinical Pediatrics

关键词儿童紫癜血小板减少性特发性诊断治疗

分类号 R725.5 [医药卫生—儿科]

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