儿童流感相关粒细胞缺乏症的临床特征分析

The clinical characteristics of influenza associated agranulocytosis in children

目的了解流感病毒感染相关粒细胞缺乏及全血细胞减少的临床特点.方法回顾性分析46例流感病毒感染相关性粒细胞缺乏症患儿的临床及实验室检查资料.结果纳入46例患儿中,≤6岁患儿占93.5%.中性粒细胞计数在病程第4天下降最明显,75%的最低值发生在病程第5、6、7天.持续时间1~7(3.4±1.6)d.44例粒细胞缺乏的患儿中,39例发现粒细胞缺乏时,体温已正常,其它5例发生时体温好转.合并再生障碍性贫血的病例,粒细胞下降的同时,红系及巨核系下降明显.合并支原体及腺病毒感染的患儿炎症因子明显升高,红系及巨核系轻度下降,静脉丙种球蛋白及激素治疗后,炎症因子下降,血三系升高.结论儿童免疫功能未成熟可能是流感相关粒细胞缺乏的主要原因.流感病毒感染相关性粒细胞缺乏症中性粒细胞计数随病程规律性变化,持续短暂时间后缓慢恢复,预后良好.

Objective To investigate the clinical features of severe neutropenia associated with influenza vims infection.Methods The clinical and laboratory data of 46 cases of severe neutropenia associated with influenza virus infection retrospectively analyzed.Results of the 46 patients,93.5%were younger than 6 years old.The neutrophil count decreased obviously on the 4th day,and 75%of valley value were on the 5th,6th,7th day.The duration of severe neutropenia were 1〜7 days(3.43±1.63).of the 44 patients with severe neutropenia,the body temperature was normal in 39 patients and the other 5 patients were improved when severe neutropenia happened.In the aplastic anemiacase,hemoglobin and platelet count significantly declined at the same time.Inflammatory factors increased significantly in children concurrent infection o f mycoplasma and adenoviral,whose hemoglobin and platelet count decreased slightly.After intravenous ganima globulin and hormone treatment,inflammatory factors decreased,neutrophil,hemoglobin and platelet count increased.Conclusion Immature of immune system may be the main cause of influenza-associated severe neutropenia in children.The neutrophil count changes regularly with the course of disease,and recovers slowly after lasting a short period of time,and the process is good.