新疆医科大学学报

目的:探讨小儿原发性血小板减少性紫癜(ITP)的发病因素及相关检查意义。方法:选择原发性血小板减少性紫癜患儿60例,采用ELISA法进行呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感(IV)、副流感病毒(PIV)、巨细胞病毒(CMV)、EB病毒(EBV)、支原体(MP)及幽门螺杆菌(HP)抗体的检测。按血小板计数将患儿分为3组:血小板<20×109/L组29例,(20～50)×109/L组20例,>50×109/L组11例,测定3组患儿治疗前后血小板聚集功能及网织血小板百分率(RP%)、绝对值(RPs)的变化。结果:生物感染的发病率依次为RSV35.0%、ADV23.3%、MP16.7%、CMV13.3%、EBV10.0%、HP10.0%、IV5.0%、PIV3.3%;血小板<20×109/L组及(20～50)×109/L组治疗前后血小板聚集功能及网织血小板百分率、绝对值比较差异均有统计学意义(P<0.01～0.05),>50×109/L组治疗前后比较差异均无统计学意义(P>0.05);组间两两比较,治疗前<20×109/L组、(20～50)×109/L组与>50×109/L组相比血小板聚集功能及网织血小板百分率、绝对值差异有统计学意义(P<0.05),<20×109/L组与(20～50)×109/L组相比差异均无统计学意义(P>0.05);治疗后3组相比差异均无统计学意义(P>0.05)。结论:原发性血小板减少性紫癜的发病与生物感染有关,其临床表现与血小板聚集功能及网织血小板百分率、绝对值的变化有关。

Objective: To investigat pathogen and significance of related tests on children′s idiopathic thrombocytopenic purpura. Methods: RSV-antibody, ADV- antibody, IV-antibody, PIV-antibody, CMV-antibody, EB- antibody, MP-antibody, HP-antibody were tested by ELISA. A total of 60 patients with idiopathic thrombocytopenic purpura were divided into three groups according to their platelets count; To test aggregative function of platelets, the percent and abso1ute counts of reticulated platelets (RPs) in the period of onset and recovery. Results: Infection rate were 35.0% (RSV), 23.3%(ADV), 16,7%(MP), 13.3%(CMV), 10.0%(EB), 10.0%(HP), 5.0% (influenza virus, IV), 3.3% (parainfluenza virus,PIV), respectively, the difference was significant between <20×109 group and (20~50)×109/L group in the period of onset and recovery in aggregative function, RP% and RPs (P<0.01~<0.05). The difference was significant in >50×109/L group (P>0.05) . To compare between groups, the difference was significant between <20×109/L group and >50×109/L group before treatment (P<0.05), so did (20~50)×109/L group and >50×109/L group (P<0.05). There were not significant differences among three groups after treatment (P>0.05). Conclusion: Idiopathic thrombocytopenic purpura are associated with virus infection, clinical manifestation are associated with the variety of aggregative function of platelets, RP% and RPs.