儿童免疫性血小板减少性紫癜的预后因素分析

目的 分析儿童免疫性血小板减少性紫癜(immune thrombocytopenic purpura,ITP)的临床特点,对导致儿童免疫性血小板减少性紫癜的各种相关因素进行统计分析,以预测各种相关因素对儿童免疫性血小板减少性紫癜的整体预后的影响。 方法 选择2005年1月-2015年10月在温州医科大学附属第二医院儿童血液内科住院治疗的ITP患儿,对纳入诊断标准的1 150例患儿进行回顾性分析。收集其基本信息、临床特征、实验室检查结果等资料,根据患儿的性别,年龄,初诊时血常规检查的血小板数值,治疗过程中是否应用糖皮质激素和丙种球蛋白,出院时的治愈效果进行分组,整理相关数据,进行统计、单因素及多因素回归分析,计算χ2值和P值。 结果 本次研究共收集病例1 150例,男性为712例,治愈数为38例,女性为438例,治愈数为16例,单因素分析性别与治愈数的关系,χ2=1.719,P>0.05。根据年龄分组为<1岁,1~7岁和>7岁,与治愈数的单因素分析χ2=2.970,P>0.05。初诊时检查的血小板数值、应用糖皮质激素与丙种球蛋白与否与预后的单因素分析的χ2值分别为31.826、4.087、21,120,均P<0.05。多因素Logistic回归分析,影响预后的独立因素依次为血小板初始值、糖皮质激素、丙种球蛋白,P值分别为0.000、0.042、0.049。 结论 血小板初始数值、应用糖皮质激素与丙种球蛋白对儿童免疫性血小板减少性紫癜的预后有重要的预测意义,血小板初始值可作为预后的独立危险因素。必要时早期给予糖皮质激素和丙种球蛋白的干预治疗对儿童免疫性血小板减少性紫癜的预后具有积极影响,这对以后的临床工作开展具有积极推动意义。 

Analysis of prognostic factors in childhood immune thrombocytopenia

Objective Investigating the clinical characteristics of children immune thrombocytopenic purpura and analyzing relevant factors that cause immune thrombocytopenic purpura,in order to provide reference for predicting to the result of ITP. Methods Select cllildren with ITP who were hospitalized in the Second Affiliated Hospital of Wenzhou Medical University from October,2015 to January,2005,and conduct retrospective analyses for 1 150 cases meeting the inclusion criteria for patient.Collect basic information、clinical features,laboratory test results and other data to conduct univariate and multivariate analyses.To make statistical analysis according gender,age,initial platelet count,drug use,curative effect and so on. Results A total of 1 150 cases include 712 cases of male and 438 cases of female.The result between sex and prognosis of ITP was χ2=1.719,P>0.05,age groups were divided into 1 year,1 to 7 years,more than 7 years.The result between age and prognosis of ITP was χ2=2.970,P>0.05,the initial value of platelet,glucocorticoid and immunoglobulin were significant difference (P<0.05) in the prognosis of patients.According to the multivariate logistic regression analysis,the effect factors in the prognosis of the role of are initial value of platelet,corticosteroids and gamma globulin.P=0.000,0.042,0.049 respectively. Conclusion Initial platelet numerical,glucocorticoid hormone and immune globulin protein have positive significance in predicting in immune thrombocytopenia.The Initial platelet value can be used as an independent risk factor for prognosis.When necessary to give early glucocorticoid and gamma globulin therapy has a positive impact on children's immune thrombocytopenic purpura prognosis.This has a positive significance for the future clinical work.