伴乙肝病毒感染的免疫性血小板减少性紫癜45例临床分析

Clinical Analysis of 45 Hepatitis B Virus Infection-associated Thrombocytopenic Purpura

目的探讨乙型肝炎病毒（HBV）感染相关性血小板减少性紫癜的临床及血液学、免疫学特点；方法对147倒特发性血小板减少性紫癜（ITP）的患者临床资料进行回顾性分析。其中45洌HBV阳性的ITP病例（A组）与同期102例HBV阴性的ITP病例（B组）比较包括血象、骨髓象、免疫学指标等。结果A、B两组比较，A组骨髓巨核细胞成熟停滞阶段处于更早阶段；两组外周血小板计数无统计学意义，但A组血红蛋白（Hb）、白细胞（WBC）计数较B组有较明显降低；两组血清免疫球蛋白（IgG、IgA、IgM），血小板相关抗体（PAIgG）比较无统计学意义。结论HBV感染与血小板减少有一定的相关性，是血小板减少的原因之一。

Objective To study the clinical, hematological and immunologic features of hepatitis B virus （ HBV ） infection-associated thrombocytopenic purpura. Methods The clinical data of 147 patients with immune thromhocytopenie puqura（ITP） were retrospectively analyzed. The hemogram, bone marrow film, and immunologic tests of 45 HBV-positive cases（ group A）were compared with those of 102 HBV-negative ones （group B ） iu the same period. Results Comparing the two groups, the maturation of bone marrow megakaryocytes in group A was stagnant at an earlier stage; There was no statistical difference in peripheral platelet count between these two groups. However, the hemoglobin （Hb） and leukocyte （ WBC ） counts of group A were significantly lower than those of group B. There were no differences in serum immunoglobulin （ IgG, IgA, IgM ） and platelet-associated lgG （PAIgG） between them. Conclusion Hepatitis B virus infection was related to thrombocytopenia,and it could be one of the important factors leading to the onset of ITP.