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目的探讨新生儿血小板减少症(NT)的病因及临床特点。方法回顾性分析2a来本院就治的87例NT新生儿,对比不同胎龄NT的发病率,并分析病因,同时将87例NT患儿分为免疫性血小板减少组及非免疫性血小板减少组,收集各组患儿发病时间、严重程度、血小板恢复时间及住院时间等,应用SPSS10.0软件进行分析,采用单因素方差分析和χ2检验进行组间比较。结果 87例NT患儿中,足月儿41例,早产儿46例,早产儿发病率较足月儿明显增高(16.3%vs7.3%,P<0.01)。与非免疫性血小板减少症组(41例,47.1%)比较,免疫性血小板减少症组(46例,52.9%)的发病时间早、程度重,血小板恢复正常时间及住院时间均较长。针对病因给予抗感染、丙种球蛋白、地塞米松等治疗后,79例血小板恢复正常(90.8%),5例血小板计数升高后自动出院(5.8%),3例放弃治疗(3.4%)。其中5例患儿母亲经追踪检查,确诊免疫系统疾病。结论近年来免疫性血小板减少症逐渐增多,其发病早、程度重、恢复慢,但早诊断早治疗可取得良好疗效;在NT临床诊疗过程中应注意追查患儿及母亲的异常免疫因素。
Objective To investigate the etiology and clinical features of neonatal thrombocytopenia (NT). Methods A retrospective analysis of 2a hospitalized 87 NT neonates, compared the incidence of NT at different gestational age, and analyze the etiology, while 87 cases of NT children were divided into immune thrombocytopenia group and non-immune thrombocytopenia The onset time, severity, platelet recovery time and hospital stay in each group were collected and analyzed by SPSS10.0 software. One-way ANOVA and χ2 test were used to compare the groups. Results Among 87 NT children, 41 cases were full-term infants and 46 were premature infants. The incidence of preterm infants was significantly higher than that of full-term infants (16.3% vs 7.3%, P <0.01). Compared with the nonimmune thrombocytopenia group (41 cases, 47.1%), the autoimmune thrombocytopenia group (46 cases, 52.9%) had earlier onset, heavier weight, longer platelet recovery time, and longer hospital stay. After anti-infection, gamma globulin and dexamethasone were given, 79 cases of platelet returned to normal (90.8%), 5 cases of automatic discharge (5.8%) after platelet count increased, and 3 cases gave up treatment (3.4%). Five of the mothers were followed-up and diagnosed with immune system diseases. Conclusions Immune thrombocytopenia gradually increased in recent years. The onset and severity of the disease were mild and recovered slowly. However, early diagnosis and early treatment could achieve good results. In the process of clinical diagnosis and treatment of NT, abnormal immune factors should be traced to children and mothers.