Immune Thrombocytopenia In Patients With Secondary Infection Related Factors Research

Objective: Research primary immune thrombocytopenia(ITP) in the diagnosis of patients with secondary infection risk factors, within 1 year after aims to search for the clinical indicators of infection have predictive value.Methods:(1)From July 2007 to 2015 were retrospectively analyzed in our hospital 522 cases of patients with ITP, merge infection 47 cases within 1 year after diagnosis, according to the proportion of 1:1.4 randomly 67 uninfected ITP patients as controlled clinical studies both in the difference of clinical features, evaluate age /ALC/LDH in ITP patients the predictive value in the diagnosis of secondary infection after.(2)Statistical analysis: the application of SPSS 21.0 software for data analysis, analysis of measurement data using t test OR nonparametric test, analysis of variance analysis and counting data by chi-square test, multi-factor analysis USES the unconditioned Logistic regression analysis, the relative risk in the OR values and 95% confidence interval(CI). Work using ROC curve analysis of the independent risk factors predicted value and the optimal boundary value set. The independent risk factors in patients with ITP infection related analysis: difference was statistically significant(P < 0.05).Results: Cases of 114 patients with ITP, male 46 cases, female 68 cases, the median age 50(5 ~ 80), 13 cases of diabetes with/or are not associated with hypertension, the finish to follow-up, 57 patients CR(50.0%), 39 cases PR(34.2%), 18 cases NR(15.8%). Among them 4 cases(3.5%) died due to severe infection, 1 case died of intracranial hemorrhage(0.88%). 9%(47/522) of the incidence of infection within 1 year. Single factor analysis found that age, ALC, LDH, CRP, MAIPA, complications, splenectomy, Rituxan differences between infection and non- infection groups there is statistical significance(P < 0.05). On the basis of multiple factors analysis found that age, ALC, LDH are independent risk factors for infection(P < 0.05). Best age boundary value is 47.5, the area under the curve0.718(specificity of 0.612, sensitivity of 0.718), best ALC boundary value of 0.957×109 / L, the area under the curve 0.631(specificity of 0.851, sensitivity of 0.468), best LDH boundary value of 183.5 U/L, the area under the curve 0.673(specificity of 0.351, sensitivity of 0.929). Age≤47.5 years or age > 47.5 years between infection and noninfection rates were 21.2%vs58.1%, there were significant differences(P < 0.001). ALC < 0.957×109 / L and ALC ≥ 0.957×109 / L between infection and non- infection rates were 68.8%vs 30.5%, there were significant differences(P < 0.05).Conclusions: Age, ALC, LDH is independent risk factors for the development of secondary infection in one year, ITP patients could better predict the risk of infections. ITP patients for the use of mabthera and spleen resection patients clinical doctors should pay close attention to the dynamic changes of inflammatory indicators.