新诊断儿童免疫性血小板减少症与人细小病毒B19感染的相关性研究

A Retrospective Analysis of Human Parvovirus B19 Infection in Childhood Immune Thrombocytopenia

目的 明确人细小病毒B19（human parvovirus B19,B19）感染对儿童新诊断免疫性血小板减少症（immune thrombo-cytopenia, ITP）的影响. 方法 选取2011年1月~2013年12月间416例首次住院并确诊为新诊断ITP患儿为疾病组;随机选取无血小板减少及其他血液系统疾病的普通呼吸道感染住院患儿130例作为对照组. ITP患儿及对照组儿童按年龄段分为〈1岁组（n=187）、1~3岁组（n=127）、3~7岁组（n=71）、7~14岁组（n=31）. 观察各年龄段患儿B19感染率,疾病组中B19感染阳性及阴性ITP患儿经过相同治疗后的预后情况. 结果 疾病组中B19感染率较对照组各年龄段B19感染率为高,差异均无统计学意义（P均〉0.05）. ITP患儿均未接受针对B19的相关抗病毒治疗,而针对血小板减少经丙种球蛋白和（或）激素治疗后,疾病组与对照组患儿PLT缓解率差异无统计学意义,与各年龄段B19阴性的ITP患儿治疗后缓解率比较差异均无统计学意义（P均〉0.05）. 结论 B19感染可能不是新诊断ITP患儿发病的一个主要致病因素;是否治疗B19并不影响儿童急性ITP的治疗效果,因此B19感染的新诊断ITP患儿无需同时接受B19抗病毒的相关治疗.

Objective To confirm the role of human parvovirus B 19 （ B19） infection in childhood immune thrombocytopenia （ ITP） patients.Methods A total of 416 cases of newly diagnosed childhood ITP patients from Jan .2011 to Dec.2013 had been summarized to be cases group , Then a total of 130 childhood patients with common respiratory tract infection were selected randomly as the control group . All patients had been divided in grouped by age as 〈1 years group（n=187）, 1-3 years group（n=127）, 3-7 years group（n=71）, and 7-14 years group（n=31）.The incidence rate of B19 infection in all age groups, the prognosis conditions in B19 infection positive and negative groups after the same therapy protocol were obserred .Results The B19 infection rate had no statistical significance in re-search groups and control groups .And no significant difference in the same age groups compared with control groups （all P〉0.05） was found.All the ITP patients had not been given anti -B19 treatment.The PLT remission rate,respectively, after treated with the same pro-tocol including glucocorticoid and/or immunoglobulin had a declining trend as the ages increasing .The B19 infection groups of all ages al-so had no significant difference PLT remission rate had been confirmed in non -B19 infection patients in each age groups （all P〉0.05）. Conclusions B19 infection may not be a major cause in childhood newly ITP , and treatment protocol with no anti -B19 treatment had no influence on the clinical curative efficacy .