【摘要】 目的探讨乙型肝炎病毒(HBV)感染并发原发性血小板减少性紫癜(ITP)病儿临床特征、治疗反应和病程特点。方法将102例ITP病儿,分为两组,其中HBV-ITP组25例,非HBV-ITP组77例,病儿均采用大剂量丙种球蛋白、常规治疗量泼尼松、小剂量长春新碱等治疗,比较两组病儿的临床特征、治疗反应、病程特点等。结果HBV-ITP组与非HBV-ITP组治疗前外周血血红蛋白水平、血小板数量及骨髓检查方面差异无显著意义(t=0.933、1.916,2χ=5.422,P>0.05);非HBV-ITP组外周血白细胞总数较HBV-ITP组高,差异有显著意义(t=5.050,P<0.01)。采用大剂量丙种球蛋白、常规治疗量泼尼松、小剂量长春新碱治疗,HBV-ITP组疗效明显差于非HBV-ITP组(χ2=12.710、7.884,P<0.05,P=0.007)。HBV-ITP病儿较非HBV-ITP病儿易于发展为慢性。结论HBV-ITP病儿治疗反应差,病情易迁延、反复,容易向慢性转化。应进一步研究HBV感染对ITP发生发展的可能的作用机制。更多还原

【Abstract】 ObjectiveTo explore the effect of hepatitis B virus infection on the clinical characteristics,treatment reaction and prognosis of idiopathic thrombocytopenic purpura(ITP) in children.MethodsITP children,102 cases,were divided into two groups: HBV-ITP group(25 cases) and non-HBV-ITP group(77).All the children were given high dose intravenous immunoglobulin.The children who had no distinct treatment effect were given prednisone on the 4th week,and later,those who had no treatment effect were given low dose vincristine(VCR).ResultsThere was no difference in Hb and PLT in peripheral blood and bone marrow morphological examination(t=(0.933),1.916;χ~2=5.422;P>0.05),but WBC of non-HBV-ITP group was higher than that of HBV-ITP group(t=5.050,P<(0.01)).The HBV-ITP group had poor therapeutic effect than non-HBV-ITP group despite of adopting any treatment methods involving high dose immunoglobulin,prednisone and low dose of vincristine(VCR)((χ~2=)12.710,7.884;P<0.05;P=0.007).HBV-ITP children were more liable to develop chronic ITP than non-HBV-ITP.(ConclusionHBV-ITP) cases have poorer therapeutic effect.HBV-ITP cases are liable to develop chronic ITP.The probable influence of HBV infection on the occurrence and development of ITP should be further investigated.更多还原