儿童原发性免疫性血小板减少症颅内出血的多中心临床研究

Multi-center clinical study on intracranial hemorrhage in children with primary immune thrombocytopenia

目的:探讨我国儿童免疫性血小板减少症(ITP)颅内出血的发生率、相关临床因素及预后。方法:对四大儿童血液病中心2001-2011年收治的儿童ITP并发颅内出血者17例进行回顾性分析。结果:①ITP患儿颅内出血的发生率为0.46%。②颅内出血高危因素为急性患儿起病1个月内,慢性患儿病程1年后;并发感染、剧烈运动和外伤;血小板计数小于10×109/L。③并发颅内出血者病死率为11.7%。④积极治疗后预后良好。结论:ITP患儿的颅内出血是一种可以通过积极治疗而达到有效治愈的疾病,幸存下来的患儿多数无严重的神经系统后遗症。

Objective：To explore the incidence,relevant clinical risk factors and prognosis of intracranial hemorrhage in children with primary immune thrombocytopenia（ITP）. Method：Retrospective analysis was conducted on 17 cases of ITP with intracranial hemorrhage admitted in four children hematologic diseases centers during 2001 to 2011. Result：The incidence of intracranial hemorrhage in children with ITP was 0.46%.There were some risk factors for intracranial hemorrhage,such as disease course within 1 month for acute patients and longer than 1 year for chronic patients;concurrent-infection;strenuous exercise;trauma and platelet count less than 10×109/L.The motality of ITP with intracranial hemorrhage was 11.7% and the prognosis was fine after active treatment. Conclusion：Intracranial hemorrhage in children with ITP was a disease which could be effectively cured through active treatment.The majority of survivors did not have severe neurological sequelae.