特发性血小板减少性紫癜患儿B淋巴细胞刺激因子表达对感染的影响

Children with acute idiopathic thrombocytopenic expression stimulating factor B lymp-hocytes in patients with purpura and the effects on patients with nosocomial infections

目的分析急性特发性血小板减少性紫癜患儿B淋巴细胞刺激因子表达及其对医院感染的影响,为指导临床治疗方案、改善患儿预后提供理论依据。方法选取2009年4月-2012年3月收治的51例aITP患儿及同期门诊50名健康体检儿童,分别纳入患儿组及对照组,对其BLyS水平进行检测,并统计患儿组医院感染发生情况及BLyS表达与其临床参数的相关性。结果 51例aITP患儿共出现4例医院感染,感染率7.8%,其中3例消化道感染,1例呼吸道感染;患儿组BLyS、血小板相关抗体及免疫球蛋白显著高于正常对照组,两组数据对比差异有统计学意义(P<0.05),其PAIgA、PAIgM、IgA及IgM总体高于正常对照组;高BLyS水平是增加患儿医院感染风险的独立危险因素(P<0.05)。结论 aITP患儿BLyS、PAIgG及IgG显著高于标准值,显示其机体炎性反应剧烈,免疫功能受影响,而高BLyS是导致患儿医院感染的独立危险因素,因此,对于aITP患儿早期BLyS的监测是指导临床用药、改善其预后及生存质量的关键。

OBJECTIVE To analyze the children with acute idiopathic thrombocytopenic purpura（aITP）in patients with B lymphocyte stimulator（BLyS）expression and the effect of the hospital infections,and provide a theoretical basis for guiding clinical treatment program,improve the prognosis.METHODSIn our hospital from Apr.of 2007to Mar.2010 51cases of children with aITP and 50cases healthy outpatient physical children,were divided into children group and normal control group,to detect the level of BLyS,and study the relationship between hospital infections and the expression of BLyS to clinical parameters.RESULTS Among 51cases aITP four cases occured in children of hospital infection,the infection rate was 7.8%,of which 3cases of gastrointestinal infections,one case of respiratory tract infection.Children group BLyS,platelet-associated antibodies（platelet associated antibodies,PAIg）and immune globulin（immunoglobulin,Ig）was significantly higher than the control group（P〈0.05）,which PAIgA,PAIgM,IgA and IgM generally higher than the normal control group,and high BLyS levels was to increase the risk of nosocomial infections in children with an independent risk factor（P〈0.05）.CONCLUSION Children with AITP with significantly higher BLyS,PAIgG and IgG,show the inflammatory reaction,immune function affected,while high BLyS is the result of independent risk factors of nosocomial infections,therefore,for the monitoring of children with aITP early BLyS monitoring is the key to guide the clinical medication,improve the prognosis and quality of life.