Clinical Analysis Of224Cases Of Infants And Children Over The Age Of1with Severe Immune Thrombocytopenia

Immune thrombocytopenia(ITP) is a heterogeneous acquired autoimmune disease,isthe most common hemorrhagic disease in children,the incidence of ITP is about(4~5)/10million.The etiology and pathogenesis of ITP has not been fully elucidated, itis closely related to these factors：infection,vaccination, drugs,genetic susceptibilityetc.Immune dysfunction is the basic pathogenesis of ITP.Although children ITP is abegin self-limited disease,10%~20%ITP develop into chronic disease,some childrenare invalid for conventional treatment, develop into refractory ITP.In addition, forchronic ITP children，the side effects of long-term application of corticosteroidsproduce large；experience of repeated hospitalization, restriction on daily activitiesetc,will bring adverse effect on children’s physical and mental health.Children withITP is a heterogeneous group, different ages have corresponding characteristics.PurposeAnalyze the general information, clinical manifestation, laboratory examinationresults, the prognosis,etc. of immune thrombocytopenia in infants and children overthe age of1.In order to summarize the clinical characteristics of age-related,toimprove the understanding of ITP, to provide reference for further study thepathogenesis and effective treatment of ITP. Materials and methodsCollect224children with ITP first diagnosed and hospitalized in the Third AffiliatedHospital of Zhengzhou University from Jan2008to Dec2012. Divided into2groupsaccording to age: infants(≤12months) and children over the age of1(＞12months,≤168months). Retrospective analyse the general information, clinical manifestation,laboratory examination results, the prognosis,etc. Apply of SPSS17.0software forstatistical analysis.Statistical description of non-normal distribution measurement datais expressed with median, using Wilcoxon rank sum test.Count data is expressed withconstituent ratio,using chi-square test.Significant level isα=0.05.Results1.79.0%of children with ITP have premorbid triggers,97.8%of children with ITPhave bleeding manifestations, and mucocutaneous hemorrhage is the mainperformance;2.The positive rate of CMV-IgM of infants is higher than children over the age of1,the difference is statistically significant（x2=16.653，P＜0.05）;3.The positive rate of EBV-IgM of children over the age of1is higher than infants,the difference is statistically significant（x2=6.066，P＜0.05）;4.The positive rate of HP of children with ITP is76.9%,however, there is nostatistically significant difference between the two groups（x2=0.124，P＞0.05）;5.The positive rate of MP-IgM of infants is lower than children over the age of1, thedifference is statistically significant（x2=5.239，P＜0.05）;6.The initial platelet count of infants is lower than children over the age of1, thedifference is statistically significant（Z=-1.979，P＜0.05）;7.There is no statistically significant difference of megakaryocyte counts of bonemarrow smear between the two groups（Z=-0.321，P＞0.05）;8.The percentage of infantile ITP children duration>6months is lower than that ofchildren over the age of1, the difference is statistically significant（x2=8.68，P＜0.05）. Conclusions1.HCMV infection may be one of predispositions of infantile ITP；MP infection andEBV infection may be predispositions of children over the age of1；HP infection maybe related to the pathogenesis of children ITP.2.The prognosis of infantile ITP children may be better than children over the age of1.