Clinical Characteristics And Efficacy Analysis Of 280 Children With Immune Thrombocytopenia

Immune thrombocytopenia,also known as idiopathic thrombocytopenic purpura is one of the most common bleeding disorders in children,the incidence rate is about(4~5)/10 million.Most scholars believe that the disease is due to the body to produce platelet autoantibodies,resulting in excessive platelet destruction;And/or bone marrow megakaryocyte differentiation and maturation disorders,leading to thrombocytopenia,resulting in skin and mucous membranes,organ bleeding.Its pathogenesis involves humoral immunity,cellular immunity,immune regulation network abnormalities and genetic matrices.The pathogenesis involves a variety of immune cells and cytokines,with varying degrees of bleeding as the main clinical manifestations,severe ITP can cause death.ITP is mostly self-limiting in children,80% of cases in the diagnosis of platelet count can return to normal,10% to 20% of children can develop chronic ITP,about 30% of chronic ITP children are still diagnosed months or years can be self-recovery.In view of children ITP mostly self-limiting process,the main purpose of treatment is to control bleeding,reduce platelet damage,so that the number of platelets to meet the needs of the body to stop bleeding,rather than improve the PLT count to normal.To further study the characteristics of various types of clinical features and efficacy of children with ITP,in this study,we retrospectively analyzed 280 children with ITP who were hospitalized in Department of Hematology,The Third Affiliated Hospital of Zhengzhou University from July 2012 to June 2015.ObjectiveTo explore the clinical features of children with immune thrombocytopenia(ITP)and to analyze the efficacy of three different methods of treatment.Materials and MethodsWe retrospectively analyzed the clinical data and clinical characteristics of 280 ITP children with complete data and follow-up records from July 2012 to June 2015,and analyzed the clinical data and clinical data of the patients with ITP combined with steroids and hormones combined with gamma globulin,Single gamma globulin 3 different treatment options for the analysis of the effect.The results were analyzed by SPSS 21.0 software.The count data were expressed as percentage(%).The chi-square test(?2)was used to compare the data.The rank sum test was used for rank data.P <0.05 was considered statistically significant.Results(1)In this study,Newly diagnosed cases of ITP179 cases(63.93%),persistent 69 cases(24.64%),chronic 32 cases(11.43%);168 males and 112 cases,the ratio of 1.5:1.(2)There were 164 cases(58.57%)with obvious onset of onset,and the onset season was mainly in winter and spring.The age of onset was mainly infants and young children,and there was no significant difference between male and female(P> 0.05)There were 8 patients with ITP with a history of vaccination(4.88%).(3)In this study,280 cases of ITP in children with different degrees of platelet reduction;new diagnosis,persistent ITP children with platelets to severe,severe reduction of the main;chronic type showed moderate or severe reduction of the main,three types(P <0.001).In addition,275 children(98.21%)had skin and mucous membrane hemorrhage,including 26 cases of epistaxis,18 cases of gingival bleeding,12 cases of gastrointestinal bleeding,blood in the stool 2 cases,no intracranial hemorrhage performance.(4)In this study,242 cases of children with bone marrow examination: cell morphology showed hyperplasia were active or hyperplasia was active,normal red granules,of which the number of megakaryocytes increased by 204 cases(84.30%),the number of megakaryocytes in 38 cases(15.70%).(5)The total effective rates of newly diagnosed,persistent and chronic ITP combined with hormone and gamma globulin(IVIG)were 90.70%,72.72% and 66.67%,respectively,and the difference was statistically significant(P <0.05).ConclusionChildren with ITP to new diagnostic type more common,persistent,chronic type rare;age of onset to infants and young children;more than half of children before the onset of prodromal infection history;new diagnostic type ITP before the onset of many incentives.Hormone combined with gamma globulin is the most effective for newly diagnosed type ITP.