儿童特发性血小板减少性紫癜与人巨细胞病毒感染的关系

目的:探讨特发性血小板减少性紫癜的治疗转归与巨细胞病毒感染的关系。为临床合理有效地治疗ITP提供部分参考。方法:用ELISA法和流式细胞仪分别检测患儿血清HCMV抗体及外周血淋巴细胞亚群。选取2005.1-2006.12在本院儿科就诊的68例新发ITP患儿,将其按有无HCMV感染分为HCMV感染组和非感染组,比较二者的免疫状态,近期(两周)疗效,远期(六月)疾病转归之间的关系。结果:68例ITP患儿中HCMV感染30例,非HCMV感染ITP存在T淋巴细胞亚群的异常,即CD4+细胞减低,CD8+细胞升高。HCMV感染患儿T淋巴细胞总数亦降低,CD4+细胞下降明显。近期疗效无明显差异,远期转归相比较有统计学意义。结论:HCMV感染诱发的细胞免疫异常是儿童ITP发病及病程迁延的重要因素。应同时进行抗病毒和免疫治疗。

The Relationship Between Idiopathic Thrombocytopenic Purpuraand Human Cyto-megalovirus Infection in Children

Objective: Study the correlation between Human Cyto-megalovirus infection and idiopathic thrombocytopenic pur-purc.Methods: 68 children with ITP treated in our department between January,2005 to December,2006,were divided into two groups based on whether they were infected with HCMV or not.The two groups were compared with regard to the cell immune conditions,short-term effectiveness of treatment(two weeks) and long-term results(over six months).Results: 30 out of 68(44.12%)ITP children were found with HCMV infection,and the lever of CD4 in ITP with HCMV infection was lower than that in ITP without HCMV infection.Conclusion: ITP patients with HCMV infection have lowered and disordered cellular immunity,a simultaneous antivirus and immunotherapy are necessary.