| Objective Neutropenia can result from a variety of factors,with different pathogenesis and diverse clinical presentations.In this study,we analyzed and discussed the pathogenetic characteristics by recording the general data,pathogenesis,routine blood,C-reactive protein,liver function,cardiac enzymes,serum immunoglobulin-related test results,recovery time from neutropenia and follow-up outcomes of children with neutropenia,with the aim of providing additional information on the clinical features and prognosis of neutropenic children and other related contents for clinicians’ reference.Methods The clinical data of children with neutropenia who were hospitalized in our hospital from August 2021 to August 2022 were collected.According to the inclusion,exclusion and exclusion criteria,174 children with neutropenia were finally screened out.The children were divided into infant group(< 3 years old)and older children group(≥3 years old).The general data,laboratory examination results and the recovery time of neutropenia were compared between the two groups.Fifty-eight healthy children were selected by random number table method during the same period of time to compare serum immunoglobulin.SPSS23.0 statistical software was used to analyze the above data.Results1.174 children,no patients with chronic neutropenia and no neutropenic patients with family history;88(50.57%)males and 86(49.43%)females,male to female ratio 1.02:1;41(23.56%)children were seen in spring and summer(March to August),133(76.44%)in autumn and winter(September to February of the next year).The mean age was 1.91±0.77 years in the infant group and 6.14±2.04 years in the older group.The difference in gender was not statistically significant(P>0.05),and the difference in season of onset and whether medication was taken was statistically significant(P<0.05).2.174 children were seen for their primary illnesses: 135(77.59%)for respiratory diseases,19(10.92%)for gastrointestinal diseases,and 20(11.49%)for other diseases.Among the respiratory diseases,the incidence of herpes pharyngitis and acute tonsillitis was higher in the elderly group than in the infant group(P<0.05),and the incidence of acute bronchopneumonia was higher in the infant group than in the elderly group(P<0.05);among the gastrointestinal diseases,the incidence of acute diarrheal disease was higher in the elderly group than in the infant group(P < 0.05),and the incidence of acute gastroenteritis was higher in the infant group than in the elderly group(P<0.05);the incidence of other diseases was higher in the infant group than in the elderly group(P<0.05);the differences between groups in the incidence of other diseases were not statistically significant(P>0.05).3.97 cases(55.75%)of 174 children were identified as the causative pathogens,including 67 cases(69.07%)of single pathogen infections: the rate of influenza B virus infection in the infant group was higher than that in the older children group,and the rate of Mycoplasma pneumoniae infection in the older children group was higher than that in the infant group(P<0.05),while the differences in the rates of other pathogens between groups were not statistically significant(P>0.05);mixed There were 30 cases of mixed pathogen infection(30.93%),and the difference in the rate of mixed pathogen infection between the groups was not statistically significant(P>0.05).4.There were 170 neutropenic cases(97.7%)and 4 neutrophil deficient cases(2.3%)in 174 children.The distribution of ANC ranged from(0.33-1.49)× 109/L,and the median ANC was 0.98 × 109/L.WBC,LYM%,LYM#,LDH and CK-MB were higher in the infant group than in the older group,and the difference between the groups was statistically significant(P<0.05).The differences were statistically significant(P<0.05);NEUT%,NEUT# and HGB in the infant group were lower than those in the older children group,and the differences between the groups were statistically significant(P<0.05);RBC,PLT,CRP,ALT,AST and CK were not statistically significant(P>0.05).5.The case group was neutropenic children,and the control group was children with healthy physical examination in our hospital,and the differences in gender and age between the groups were not statistically significant(P>0.05).The Ig G and Ig A in the case group <3 years old were lower than the control group,and Ig M was higher than the control group,and the differences between the groups were statistically significant(P<0.05);the Ig A in the case group ≥3 years old was lower than the control group,and Ig M was higher than the control group,and the differences between the groups were statistically significant(P<0.05),and the differences between the two groups in Ig G were not statistically significant(P>0.05).6.174 children,130 cases had normalized ANC within 2 weeks of systemic hospitalization(including 4 cases of neutrophil deficient children),and 44 children were discharged from the hospital without normalized ANC due to cure of the original disease.130 children with systemic hospitalization,the average time required for normalization of ANC was(7.21±2.40)days,and 106 cases had normalized ANC in the first week of treatment(81.54%),and the recovery rate of the older children group was higher than that of the infant group,and the difference between the groups was statistically significant(χ 2=4.607,P<0.05);16 cases in the infant group and 8cases in the older children group had normalized ANC in the first 2 weeks of treatment.The results showed that 18 infants and 26 older children had normalized their ANC within 2 weeks after the first visit.Conclusions1.Neutropenia has the highest incidence in the fall and winter,with a higher incidence in infants than in older children.2.Infectious diseases of the respiratory tract were the most common primary causes,with a higher incidence of herpes pharyngitis and acute tonsillitis in older children and a higher incidence of acute bronchopneumonia in infants and children.Among single pathogen infections,the rate of influenza B virus infection in infants and children is higher,and the rate of Mycoplasma pneumoniae infection in older children is higher.3.Neutropenic children are associated with immune dysfunction.4.The absolute neutrophil values normalize within 1 week of hospitalization in most children,and the recovery is faster in older children compared to infants. |
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