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目的探讨B19病毒感染相关性小儿重症血液病的临床特征与治疗。方法回顾性总结51例小儿B19病毒感染相关性重症血液病的临床资料 ,分析其治疗与预后。结果检测B19抗原或抗体阳性加B19DNA阳性 ,确定为B19病毒感染的重症血液病患儿51例中 ,急性血小板减少性紫癜32例 ,急性再生障碍性贫血9例 (包括纯红细胞再生障碍性贫血3例 ) ,急性白血病合并重度贫血6例 ,溶血性贫血并发急性再障危象3例 ,噬血细胞综合征1例 ;所有患儿均重度或极重度血细胞减少 ,38例合并内脏出血 ,12例合并细菌或真菌感染。经应用大剂量丙种球蛋白 ,同时加强对症治疗与支持疗法、防治严重并发症 ,结果好转和治愈48例 (94.12 % ) ,死亡3例 (5.88 % )。结论B19病毒感染相关性小儿重症血液病应加强抗病毒及止血的治疗。
Objective To investigate the clinical features and treatment of pediatric severe hematological diseases associated with B19 virus infection. Methods The clinical data of 51 cases of B19-associated severe hematological diseases in children were retrospectively reviewed, and the treatment and prognosis were analyzed. Results Of the 51 patients with severe hematologic diseases diagnosed as B19 virus infection, 32 cases were positive for B19 antigen or antibody plus B19 DNA positive, 13 cases were acute thrombocytopenic purpura, 9 cases were acute aplastic anemia (including pure erythrocytosis aplasia 3 Cases), acute leukemia combined with severe anemia in 6 cases, hemolytic anemia complicated by acute aplastic anemia in 3 cases, hemophagocytic syndrome in 1 case; all children were severe or severe cytopenia, 38 cases with visceral hemorrhage, 12 cases of merger Bacterial or fungal infections. The application of high-dose gamma globulin, while strengthening symptomatic treatment and supportive therapy, prevention and treatment of serious complications, the results improved and cured in 48 cases (94.12%), 3 patients died (5.88%). Conclusion B19 virus infection-related pediatric severe hematological disease should be strengthened antiviral and hemostatic treatment.