新生儿类白血病反应的病因分析

Etiology Analysis of Leukemoid Reaction in Neonate

目的探讨引起新生儿类白血病反应这一临床现象的病因。方法回顾苏州大学附属儿童医院NICU收治的10例新生儿类白血病反应的血常规,结合患儿的临床症状、体征、实验室检查及胸片等来分析新生儿类白血病反应的病因。结果新生儿类白血病反应的病因:①感染性因素如细菌、病毒、梅毒、支原体、霉菌等;②非感染性因素如早产、低出生体重儿、严重出血、急性溶血、异常增多的细胞因子、母亲因素(如绒毛膜炎等)、产前使用激素等,其中以早产、低出生体重儿发生新生儿类白血病反应较多见。结论新生儿类白血病反应在临床并不少见,尤其在早产儿、低出生体重儿,可达1.3%,而导致类白血病反应的病因在新生儿是多方面的,有感染性和非感染性两方面因素。大部分无需特殊治疗,去除病因后,可自行消失。但有很少一部分有发展成白血病的可能,故对该类患儿应加强随访。

Objective To study the etiology of Leukemoid reaction in neonates. Methods Retrospective method was applied to analyze 10 cases neonates with Leukemoid reaction in NICU. Clinical symptoms, signs, lab findings and chest X ray were ob- served. Results The etiology of Leukemoid reaction includes infections（such as bacteria, viruses, syphilis, mycoplasma, fungus, etc ） and non-infections （ such as prematurity, low birth weight, severe bleeding, acute hemolysis, maternal factors, etc）. These premature and neonates with low birth weight were more likely to get Leukemoid reaction. Conclusion The etiology of Leukemoid reaction includes infections and non-infections. The incidence of Leukemoid reaction in premature babies and neonates with low birth weight reaches 1.3%. Most of the patients need no special treatment. The symptoms may disappear when the causes were removed. But some patients may develop with leukemia, so follow-up should be enhanced.