儿童免疫性血小板减少症慢性发展的危险因素分析

Analysis of risk factors for chronic development of childhood immune thrombocytopenia

目的探讨儿童免疫性血小板减少症慢性发展的危险因素。方法回顾性选取我院2017年1月至2020年6月收治的免疫性血小板减少症患儿60例,根据患儿预后情况将其分为预后良好组(34例)和预后不良组(26例),两组患儿均根据出血症状给予治疗方案,并治疗14 d。对其临床基本资料进行分析与整理,进行单因素分析,并对其中差异有统计学意义的因素进行多因素Logistic回归分析。结果单因素分析结果显示,预后不良组中发病前有感染史或预防接种史的患儿占比均显著高于预后良好组,且预后不良组患儿外周血淋巴细胞绝对值水平低于预后良好组,差异有统计学意义(P<0.05)。多因素非条件Logistic回归分析结果显示,发病前有感染史或预防接种史、外周血淋巴细胞绝对值水平较低均为免疫性血小板减少症患儿慢性发展的危险因素(OR=2.428,2.314,P<0.05)。结论发病前有感染史或预防接种史、外周血淋巴细胞绝对值水平低易对免疫性血小板减少症患儿预后产生不良影响,临床需注意对其危险因素进行有效防治,抑制病情发展,促进患儿快速恢复,并改善其生活质量。

Objective To explore the risk factors for the chronic development of childhood immune thrombocytopenia.Methods A retrospective selection of 60 children with immune thrombocytopenia admitted to our hospital from January 2017 to June 2020 were divided into a good prognosis group(34 cases)and a poor prognosis group(26 cases)according to the prognosis of the children;both groups of children were given treatment based on bleeding symptoms and treated for 14 days.Analyze and sort the basic clinical data,conduct single factor analysis,and conduct multivariate Logistic regression analysis on factors with statistically significant differences.Results Univariate analysis showed that the proportion of children with a history of infection or vaccination before the onset in the poor prognosis group was significantly higher than that in the good prognosis group,and the peripheral blood ALC level of the children in the poor prognosis group was lower than that in the good prognosis group(P<0.05).The results of multivariate unconditional Logistic regression analysis showed that a history of infection or vaccination before the onset and low ALC levels in peripheral blood were risk factors for the chronic development of children with immune thrombocytopenia(OR=2.428,2.314,P<0.05).Conclusion A history of infection or vaccination before the onset of the disease and a low absolute level of peripheral blood lymphocytes are likely to have a negative impact on the prognosis of children with immune thrombocytopenia.Clinical attention should be paid to effective prevention and treatment of the risk factors,inhibit the development of the disease,promote the rapid recovery of children,and improve their quality of life.