婴儿急性特发性血小板减少性紫癜与巨细胞病毒感染关系探讨

CORRELATION BETWEEN INFANT IDIOPATHIC THROMBOCYTOPENIC PURPURA AND CYTOMEGALOVIRUS INFECTION

目的:探讨婴儿期急性特发性血小板减少性紫癜(ITP)与人巨细胞病毒(CMV)感染及免疫功能的关系。方法:对52例ITP患儿(病例组)及32例正常婴儿(对照组)检测血清CMV-DNA及CMV-IgM、IgG抗体,比较两组差异;对52例ITP病例组患儿进行末稍血T细胞亚群检测,比较CMV-IgM阳性者与阴性者T细胞亚群差异;对CMV-IgM阳性者分更昔洛韦(GCV)治疗组和非GCV治疗组,比较两组治疗后末稍血血小板数量。结果:两组患儿CMV-DNA阳性数、CMV-IgM、IgG抗体阳性数比较,差异有统计学意义(均P<0.01);病例组CMV-IgM阳性者与阴性者T细胞亚群CD4+、CD8+及CD4+/CD8+比较,差异有统计学意义(均P<0.01);对CMV-IgM阳性者加用GCV治疗,血小板计数有明显改善。结论:CMV是ITP的重要致病因素之一,在临床上建议对CMV相关性ITP加用GCV治疗。

OBJECTIVE： To determine correlation between acute infant idiopathic thrombocytopenic purpura （ITP） and cytomegalovirus infection （CMV）. METHOD ： Serumal CMV - DNA and antibody of CMV - IgM, IgG in 52 ITP patients and 32 healthy individuals were detected and compared. T cell subgroup was detected in the ITP group and compared between CMV - IgM positive and negative patients. Amount of peripheral blood platelet in MCV - IgM positive patients was compared between between ganciclovin （GCV） treated and non - ganciclovin treated group. RESULTS ： Positive rate of MCV - DNA, CMV - IgM, IgG were significantly different between the two groups （ P 〈0. 01 ） ; T cell subgroup CD4 ＋, CD8 ＋ 及CD4 ＋ /CD8 ＋ was significantly different between CMV - IgM positive and negative patients in the ITP group （ P 〈 0. 01 ） ; GCV could remarkably increased amount of platelet for CMV - IgM positive patients. CONCLUSION ： CMV is one of important etiological factor of ITP and GCV is suggested for ITP patients of CMV - correlated.