外周血三系细胞同时降低患儿的临床分析

Clinical Analysis of Children with Simultaneous Peripheral Blood Cell Reduction

目的 探讨导致患儿外周血三系细胞同时降低的病因及其相关临床血液学指标变化.方法 选择2008年1月至2014年2月在安徽医科大学附属安徽省立医院儿科和安徽省立医院西区儿童血液科,由于外周血三系细胞同时降低住院治疗的100例儿童的临床病历资料为研究对象,对其进行回顾性分析.按照疾病类别,将其分为再生障碍性贫血组（n=45）,急性白血病组（n=27）及感染相关性全血细胞减少组（n=11）等9个组.对每组患儿分别进行贫血分度,检测中性粒细胞计数、血小板计数等,并进行相关统计学分析（本研究遵循的程序符合上述2家医院人体试验委员会制定的伦理学标准,得到该委员会批准）.结果 本组100例外周血三系细胞同时降低住院儿童的最常见病因依次为再生障碍性贫血、急性白血病、感染性疾病、噬血细胞综合征和骨髓增生异常综合征等.外周血三系细胞同时降低导致的中度与重度贫血患儿（81.00％）显著多于轻度与极重度贫血患儿（19.00％）,并且差异有统计学意义（x2=6.54,P＜0.05）.再生障碍性贫血患儿中,血小板计数≤20×109/L发生率,显著高于血小板计数＞20×109/L者（分别为34％与11％）,差异有统计学意义（x2=6.85,P＜0.05）.结论 导致患儿外周血三系细胞同时降低的病因各异,其中以再生障碍性贫血、急性白血病、感染性疾病、噬血细胞综合征和骨髓增生异常综合征为主.

Objective To study the etiopathogenisis of children with simultaneous peripheral blood cell reduction and its associated clinical hematological changes.Methods From January 2008 to February 2014,a total of 100 cases clinical data of children with simultaneous peripheral blood cell reduction in Department of Pediatrics,Affiliated Anhui Provincial Hospital,Anhui Medical University,and Children＆#39;s Department of Hematology,Western Hospital,Anhui Provincial Hospital were recruited,and study by retrospective statistical analysis method.According to disease categories,they were divided into aplastic anemia group（n =45）,acute leukemia group（n =27）,infection related pancytopenia group（n =11） and other 9 groups.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the 2 hospital above.Results The top five etiopathogenisises in children with simultaneous peripheral blood cell reduction were aplastic anemia,acute leukemia,infectious diseases,hemophagocytic syndrome and myelodysplastic syndrome in this study.Among them,children with moderate and severe anemia （81.00%） were significantly higher than those in children with mild or very severe anemia （19.00 %）,and there had statistical significance （x2 =6.54,P 〈 0.05）.Children with aplastic anemia,whose incidence rate of platelet count ≤20 × 109/ L were significantly higher than those platelet count〉 20× 109/ L （34% and 11 %,respectively）,and there had statistical significance （x2=6.85,P〈0.05）.Conclusions Etiopathogenisis of children with simultaneous peripheral blood cell reduction is vary.Mainly include aplastic anemia,acute leukemia,infectious disease,hemophagocytic syndrome and myelodysplastic syndromes and etc..