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通过韩国公共卫生数据分析探讨儿童免疫性血小板减少症的流行病学及病毒病因

Epidemiology and Viral Etiology of Pediatric Immune Thrombocytopenia through Korean Public Health Data Analysis.

作者信息

Lim Jae Hee, Kim Yu Kyeong, Min So Hyeon, Kim Sang Won, Lee Young Hwan, Lee Jae Min

机构信息

Department of Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea.

Medical Research Center, College of Medicine, Yeungnam University, Daegu 42415, Korea.

出版信息

J Clin Med. 2021 Mar 25;10(7):1356. doi: 10.3390/jcm10071356.

Abstract

Immune thrombocytopenic purpura (ITP) is prevalent in children aged 2-5 years but may occur in all pediatric age groups. In 50-60% of pediatric patients, ITP is preceded by an upper respiratory tract infection 1-4 weeks before its onset. In this study, the relationship between the development of ITP and viral infections in children was assessed. We analyzed data of 6487 patients aged < 18 years with incident ITP from the Health Insurance Review and Assessment Open Access Big Data Platform (2015 to 2018) and the Korea Disease Control and Prevention Agency. The monthly positive detection rate (PDR) of seven respiratory and four acute diarrhea viruses was calculated. The virus PDR seasonal trend data was analyzed through ARIMA modeling. The ITP diagnostic data and prevalence of viral infection 1 and 2 months prior were analyzed using the Granger test. The overall male to female (M/F) ratio was 1.2, whereas it was 1.4 in the youngest age group (< 1 year). The overall ITP incidence rate was 18.1 per 100,000 person-years. Respiratory syncytial virus, rhinovirus, rotavirus, and astrovirus infections influenced ITP occurrence in children. However, rotavirus infection is positively associated with the etiology of ITP after 1-2 months.

摘要

免疫性血小板减少性紫癜(ITP)在2至5岁的儿童中较为常见,但也可能发生于所有儿科年龄组。在50%-60%的儿科患者中,ITP发病前1至4周有上呼吸道感染史。本研究评估了儿童ITP的发生与病毒感染之间的关系。我们分析了来自健康保险审查与评估开放获取大数据平台(2015年至2018年)和韩国疾病控制与预防机构的6487例18岁以下新发ITP患者的数据。计算了七种呼吸道病毒和四种急性腹泻病毒的月度阳性检出率(PDR)。通过自回归积分移动平均(ARIMA)模型分析病毒PDR的季节性趋势数据。使用格兰杰检验分析ITP诊断数据以及发病前1个月和2个月的病毒感染患病率。总体男女比例为1.2,而在最年幼年龄组(<1岁)中为1.4。ITP总体发病率为每10万人年18.1例。呼吸道合胞病毒、鼻病毒、轮状病毒和星状病毒感染影响儿童ITP的发生。然而,轮状病毒感染在1至2个月后与ITP的病因呈正相关。

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