Kvezereli-Kopadze M A, Kvezereli-Kopadze A N, Mtvarelidze Z G
Georgian Med News. 2009 Sep(174):50-5.
Idiopathic thrombocytopenic purpura (ITP) of Childhood is a common hemorrhagic diathesis. The purpose of the present work is to summarize the results of 20-year observation over children suffering ITP, to record certain progress in diagnosing and treatment of this disease and to raise the problems still to be solved. The authors have been observing 181 ITP patients (girls 89, boys 92) at the age of 3 months up to 15 years. Childhood ITP mostly occurs at the age of 1 to 6 year i.e. in the so called "critical period" of immune system forming. Several peculiar cases were identified among infants and the children above 10 years old. Clinical manifestation of all the ITP patients was characterized with cutaneous hemorrhagic syndrome. 95% of childhood cases showed deep thrombocytopenia with the thrombocyte level <30X10 9/l. Most of the patients suffered acute form of ITP (87,9%). In the majority of cases illness took its normal predictable course after the glucocorticosteroid therapy. In heavy cases the combination of glucocorticosteroid and intravenous immunoglobulin is recommended. The indications of splenectomy were considered to be heavy, life -threatening, excessive bleeding, mainly in cases of chronic, steadily recurrent forms of ITP. Remissions were achieved in most of cases.
儿童特发性血小板减少性紫癜（ITP）是一种常见的出血性素质。本研究的目的是总结对ITP患儿20年的观察结果，记录该疾病在诊断和治疗方面取得的某些进展，并提出仍有待解决的问题。作者观察了181例年龄在3个月至15岁之间的ITP患者（女孩89例，男孩92例）。儿童ITP大多发生在1至6岁，即免疫系统形成的所谓“关键时期”。在婴儿和10岁以上儿童中发现了几例特殊病例。所有ITP患者的临床表现均以皮肤出血综合征为特征。95%的儿童病例表现为严重血小板减少，血小板水平<30×10⁹/L。大多数患者患有急性ITP（87.9%）。在大多数情况下，糖皮质激素治疗后病情呈正常可预测的病程。在重症病例中，建议联合使用糖皮质激素和静脉注射免疫球蛋白。脾切除术的指征被认为是重症、危及生命、出血过多，主要适用于慢性、反复发作的ITP病例。大多数病例实现了缓解。
