阿卜杜勒阿齐兹国王医疗城和阿卜杜拉国王专科医院儿童免疫性血小板减少性紫癜患者的临床特征及转归：一项10年研究

Clinical Characteristics and Outcomes of Pediatric Patients With Immune Thrombocytopenic Purpura in King Abdulaziz Medical City and King Abdullah Specialist Children's Hospital: A 10-Year Study.

作者信息

Alwadi Khalid W, Alomari Ali, Alrugaib Abdulmohsen K, Alrubayea Abdulrahman, Alzoman Musab, Alkahtani Fahad

机构信息

Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, SAU.

Pediatric Hematology/Oncology, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, SAU.

出版信息

Cureus. 2020 Nov 6;12(11):e11366. doi: 10.7759/cureus.11366.

DOI:10.7759/cureus.11366

PMID:33304699

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7721069/

Abstract

Background Immune thrombocytopenic purpura (ITP) can be defined as "an immune-mediated acquired disease characterized by a transient or persistent decrease in the platelet count". Medical treatment is usually not needed but, in some cases, intravenous immunoglobulin G (IVIG), corticosteroids, and anti-D immunoglobulins are used. Splenectomy can be an option for chronic cases with no response to pharmacological treatments. The aim of this study was to describe the clinical characteristics and outcomes of pediatric patients with ITP in King Abdulaziz Medical City (KAMC) and King Abdullah Specialist Children's Hospital (KASCH) in a 10-year period. Methods The study was conducted at KAMC and KASCH. The number of recorded cases was 95, which included all ITP patients aged 1 to 14 from both genders who presented to KAMC previously and KASCH currently from January 1, 2007, to December 31, 2017. The data analysis and entry were performed using the Statistical Package for the Social Sciences (SPSS) version 25 (IBM Corp., Armonk, NY). Results Among 95 pediatric patients with ITP, 51 (53.7%) were males and 44 (46.3%) were females, with a median age of 4.00 ± 3.977. Among them, 84 (92.7%) had purpura, 38 (46.3%) had epistaxis, 43 (39%) had petechia, 17 (24.3%) had fever, and 20 (19.5%) had gum bleeding. Out of 95 patients, 91 (95.8%) were given treatment. Out of those 91 patients who were given treatment, IVIG was used in 84 (92.3%), steroids were used in 44 (48.4%), 14 patients received platelet transfusion (15.4%), rituximab was used in 7 (7.7%), and splenectomy was done in 5 (5.5%); 32 (33.7%) cases were considered chronic (more than one year), and 63 (66.3%) were considered acute. Among chronic patients, only one death was recorded, while in acute, no deaths were recorded. Conclusion In conclusion, ITP is an autoimmune disease that decreases platelet count. The results showed a significant difference in treatment compared to the literature but similar results in other aspects.

摘要

背景免疫性血小板减少性紫癜（ITP）可被定义为“一种免疫介导的获得性疾病，其特征为血小板计数短暂或持续下降”。通常无需药物治疗，但在某些情况下，会使用静脉注射免疫球蛋白G（IVIG）、皮质类固醇和抗-D免疫球蛋白。脾切除术可作为对药物治疗无反应的慢性病例的一种选择。本研究的目的是描述在10年期间，阿卜杜勒阿齐兹国王医疗城（KAMC）和阿卜杜拉国王专科医院（KASCH）中ITP儿科患者的临床特征和结局。方法该研究在KAMC和KASCH进行。记录的病例数为95例，包括2007年1月1日至2017年12月31日期间曾就诊于KAMC且目前就诊于KASCH的所有1至14岁的ITP患者，涵盖了男女两性。使用社会科学统计软件包（SPSS）25版（IBM公司，纽约州阿蒙克）进行数据分析和数据录入。结果在95例ITP儿科患者中，男性51例（53.7%），女性44例（46.3%），中位年龄为4.00±3.977岁。其中，84例（92.7%）有紫癜，38例（46.3%）有鼻出血，43例（39%）有瘀点，17例（24.3%）有发热，20例（19.5%）有牙龈出血。95例患者中，91例（95.8%）接受了治疗。在接受治疗的91例患者中，84例（92.3%）使用了IVIG，44例（48.4%）使用了类固醇，14例患者接受了血小板输注（15.4%），7例（7.7%）使用了利妥昔单抗，5例（5.5%）进行了脾切除术；32例（33.7%）病例被认为是慢性的（超过一年），63例（66.3%）被认为是急性的。在慢性患者中，仅记录到1例死亡，而急性患者中无死亡记录。结论总之，ITP是一种导致血小板计数降低的自身免疫性疾病。结果显示，与文献相比，治疗方面存在显著差异，但在其他方面结果相似。