小儿免疫性血小板减少症30例临床分析

Clinical analysis of 30 cases of pediatric immune thrombocytopenia

目的探讨小儿免疫性血小板减少症(ITP)的临床特点及预后。方法对30例ITP患儿的临床资料进行分析,建立档案,分析患儿的出血症状、血常规、骨髓象、治疗依从情况及预后等。结果全部病例均有皮肤出血,鼻出血5例(17%),消化道出血3例(10%),颅内出血1例(3%),死亡1例,合并布加综合征(腹水、黄疸、肝功能损伤)1例(3%),15例随访1年余已完全康复,10例血小板未恢复正常但已无出血症状,转为Evans综合征1例,转为慢性1例。结论 ITP以持续的血小板计数减少为特征,临床表现为皮肤、黏膜自发性出血,血块收缩不良,出血时间延长等,且影响其预后的因素是多方面的。

Objective To investigate the clinical characteristics and prognosis of pediatric immune thrombocytopenia （ITP）. Methods Clinical data of 30 children with ITP was analyzed and filed.The children＇s bleeding symptom,blood routine,myelogram,treatment compliance and prognosis were analyzed. Results All the patients had dermatorrhagia,a- mong them, 5 （17%） patients had nose bleeding,3 （10%） patients had gastrointestinal bleeding and 1 （3%） patient had intracranial bleeding,one patient died and 1 （3%） patient was complicated by Budd-Chiari syndrome （ascites,jaundice, liver damage）.15 patients fully recovered after more than 1 year＇s follow-up,and platelet status in 10 patients did not reach normal but stopped bleeding,one patient progressed into Evans syndrome,one patient transferred into chronic disease. Conclusion ITP is characterized by thrombocytopenia,its manifestion is spontaneous hemorrhage of skin,mu- cous membrane,defective blood clot retraction,prolonged bleeding and so on,and the factors influencing the prognosis is in many aspects.