Wolach B, Morag H, Drucker M, Sadan N
Department of Pediatrics, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.
Pediatr Infect Dis J. 1990 Oct;9(10):718-21. doi: 10.1097/00006454-199010000-00007.
Thrombocytosis is seen in association with many conditions, including infectious diseases. We studied thrombocytosis after severe bacterial infections, particularly pneumonia with empyema in children. A systematic survey of the phenomenon was conducted. Twenty-seven children admitted for pneumonia with empyema were studied. Thrombocytosis (platelet counts greater than 500 x 10(3)/microliters) was present in 92.5%. Platelet counts reached their maximum at 15.1 +/- 3.7 days (range, 7 to 25) and declined to normal after 3 weeks of illness. Compared with a healthy control group, significant thrombocytosis, but of lower incidence, was also noted in children with lobar pneumonia without pleural effusion, bacterial meningitis and osteomyelitis. Platelet functions were examined in seven of the children but no abnormalities were observed. Bone marrow aspiration of three children with pneumonia and empyema showed megakaryocytic hyperplasia. We found no correlation between thrombocytosis, neutrophilia, fever, the clinical course, complications, prognosis or treatment. Neither thromboembolic nor hemorrhagic phenomena were observed.
血小板增多症可见于多种情况,包括感染性疾病。我们研究了严重细菌感染后的血小板增多症,尤其是儿童肺炎合并脓胸的情况。对这一现象进行了系统的调查。研究了27例因肺炎合并脓胸入院的儿童。92.5%的患儿存在血小板增多症(血小板计数大于500×10³/微升)。血小板计数在15.1±3.7天(范围7至25天)达到峰值,病程3周后降至正常。与健康对照组相比,在无胸腔积液的大叶性肺炎、细菌性脑膜炎和骨髓炎患儿中也观察到明显的血小板增多症,但发生率较低。对7名患儿进行了血小板功能检查,但未观察到异常。对3例肺炎合并脓胸患儿进行骨髓穿刺显示巨核细胞增生。我们发现血小板增多症与中性粒细胞增多、发热、临床病程、并发症、预后或治疗之间无相关性。未观察到血栓栓塞或出血现象。