论文部分内容阅读
目的:研究新生儿同种免疫性血小板减少症(AIT+)及非同种免疫性血小板减少症(AIT-)的临床特点,为新生儿血小板减少症的诊疗提供帮助。方法:对120例中重度血小板减少症患儿的临床资料进行回顾性分析,按照血清学检测分为AIT+组(34例)和AIT-组(86例)。统计分析患儿的胎龄、分娩方式、出生体重、Apgar评分、血小板计数、出血症状、治疗效果及病程等。结果:AIT+组与AIT-组除在分娩方式(剖宫产)上差异无统计学意义外,AIT+组的胎龄、出生体重、Apgar评分、发生严重血小板减少、出血症状和颅内出血的比例均明显大于AIT-组,血小板计数显著低于AIT-组(均P<0.01)。与AIT-组比较,AIT+组对治疗的反应较好,病程较短(均P<0.01)。结论:新生儿血小板减少症发病率高,病程多为自限性,预后较好。其中AIT+患儿出生时一般情况好,但血小板进行性下降,血小板减少严重,多伴出血症状,颅内出血发生率高,对早期严重血小板减少新生儿需行血清学检测以确认AIT。一旦疑似AIT,合理快速的处理很重要,包括行头部影像学检查、静脉输注丙种球蛋白、辐照血小板等。
Objective: To study the clinical features of AIT + and AIT- in neonates and to provide assistance in the diagnosis and treatment of neonatal thrombocytopenia. Methods: The clinical data of 120 children with moderate to severe thrombocytopenia were retrospectively analyzed. According to the serological tests, they were divided into AIT group (34 cases) and AIT group (86 cases). Statistical analysis of children with gestational age, mode of delivery, birth weight, Apgar score, platelet count, bleeding symptoms, treatment and duration of disease. Results: The gestational age, birth weight, Apgar score, incidence of severe thrombocytopenia, bleeding symptoms and intracranial hemorrhage in AIT + group were all significantly lower than those in AIT + group except for delivery mode (cesarean section) Significantly greater than the AIT-group, platelet count was significantly lower than the AIT-group (P <0.01). Compared with AIT-group, AIT + group responded better to treatment with shorter duration (all P <0.01). Conclusion: The incidence of neonatal thrombocytopenia is high, the course of the disease is mostly self-limited, and the prognosis is good. The AIT + children at birth are generally good, but the progressive decline of platelets, severe thrombocytopenia, with multiple bleeding symptoms, high incidence of intracranial hemorrhage, early severe thrombocytopenia in newborns to undergo serological tests to confirm AIT. Once the suspected AIT, reasonable and rapid processing is very important, including line head imaging, intravenous gamma globulin, irradiated platelets and so on.