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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 investigate the pathogenesis of idiopathic thrombocytopenic purpura (ITP) in children and its significance. Methods: Sixty children with idiopathic thrombocytopenic purpura were enrolled in this study. The respiratory syncytial virus (RSV), adenovirus (ADV), influenza (IV), parainfluenza virus (PIV), cytomegalovirus (CMV) ), Epstein-Barr virus (EBV), Mycoplasma (MP) and Helicobacter pylori (HP) antibodies. According to platelet count, the children were divided into 3 groups: 29 cases of platelet count <20 × 109 / L, 20 cases of (20 ~ 50) × 109 / L group and 11 cases> 50 × 109 / L group Changes of platelet aggregation and reticulation platelet percentage (RP%) and absolute value (RPs) before and after treatment. Results: The incidence rates of biological infection were RSV35.0%, ADV23.3%, MP16.7%, CMV13.3%, EBV10.0%, HP10.0%, IV5.0%, PIV3.3% The levels of platelet aggregation and the percentage of reticulated platelets in 20 × 109 / L group and (20 ~ 50) × 109 / L group before and after treatment were significantly different (P <0.01 ~ 0.05) and> 50 × 109 / L group before and after treatment, there was no significant difference (P> 0.05) between the two groups before and after treatment; before treatment, 20 × 109 / L group, 20-50 × 109 / L group and> 50 × 109 / L group compared with platelet aggregation function and reticulated platelet percentage, absolute difference was statistically significant (P <0.05), <20 × 109 / L group and (20 ~ 50) × 109 / L group, no significant difference (P> 0.05). There was no significant difference between the three groups after treatment (P> 0.05). Conclusion: The incidence of idiopathic thrombocytopenic purpura is related to biological infection. The clinical manifestations are related to the platelet aggregation function and the percentage of reticulated platelets and absolute value.