特发性血小板减少性紫癜与人细小病毒B_(19)的关系

Relationship between human parovirous B_( 19) infection and idiopathic thrombocytopenic purpura

目的 探讨特发性血小板减少性紫癜 (ITP)与人细小病毒B19感染性的关系。方法 采用巢式聚合酶链反应技术分别对 6 3例ITP患儿的血清、38例ITP患儿的骨髓液检测人细小病毒B19 DNA。并与对照组进行对比。结果 ① 6 3例ITP静脉血中人细小病毒B19 DNA阳性 12例 ,阳性率为 19 1% ,186例健康儿童 11例阳性 ,阳性率为 5 91%。血清的ITP组与对照组差异有显著意义 (χ2 =9 6 8,P <0 0 1)。② 38例ITP患儿的骨髓液中人细小病毒B19 DNA 16例阳性 ,阳性率为 4 2 1% ,对照组 30例阳性 3例 ,阳性率为10 % ,骨髓ITP组与对照组差异有显著意义 (χ2 =8 5 8,P <0 0 1)。③血清的ITP组 12例阳性病例中 ,11例是急性ITP ,阳性率为 2 3 4 % ;1例是慢性ITP ,阳性率为 5 9% ,差异有显著意义 (χ2 =3 0 9,P <0 0 5 )。骨髓的ITP组急性 2 9例 ,阳性 15例 ,阳性率为 5 1 7% ;慢性 9例 ,阳性 1例 ,阳性率为 11 1%。ITP组与对照组差异有显著意义 (χ2 =4 6 5 ,P <0 0 5 )。男女之间无差异。结论 ①ITP人群有较高的B19感染率 ,一部分ITP病儿与人细小病毒B19感染密切相关。②临床上一部分ITP患儿的发病可能为人细小病毒B19感染所导致。③B19感染相关性ITP以急性ITP为主。

Objective To study the relationship between human parovirus B 19 (HPV B 19 ) infection and idiopathic thrombocytopenic purpura(ITP).Methods Nested polymerase chain reaction was used to detect HPV B 19 DNA in serum specimens from 63 children and in bone marrow specimens from 38 children with ITP.One hundred and eight six normal children and thirty cases of macrocytic anemia(MA) and iron deficiency anemia were chosen as control.Results ①In serum specimens in 12 of 63 cases of ITP and 11 of 186 healthy children were positive for HPV B 19 DNA,with a positive rate of 19.1% and 5.91%,respectively(χ 2=9.68,P<0.01).②Sixteen of 38 cases of ITP and 3 of 30 cases of MA and iron deficiency anemia were positive for HPV B 19 DNA,with a positive rate of 42.1% and 10%,respectively(χ 2=8.58,P<0.01).③There was a significant difference in detective rates between different stage of ITP(acute stage vs. chronic stage).There was no difference in the HPV B 19 DAN detective rates concerned with genders.Conclusion ①The ITP cases exhibite a close association with HPV B 19 infection.②Most attacks of ITP might be correlated to HPV B 19 infection.③Most HPV B 19 infected ITP cases are in acute stage of ITP.However,the HPV B 19 DNA detective rate is not correlated to the genders.