感染相关性儿童中性粒细胞减少症280例临床分析

摘要

Objectives To explore the related factors and clinical characteristics of infection associted neutropenia in children. Methods Retrospectively reviewed the medical records of 280 neutropenia in-patients from September 2010 to August 2011. Their clinical features, laboratory investigations, treatment and prognosis were analyzed. Serum immunoglobulins were compared with 65 healthy control children. Results Among 280 children, 78% of them were younger than 3 years old and 62.5% were male, arid 90.7% were with respiratory infection. The medical records indicated the number of patients was slightly increased in January, March and August when compared with other months throughout the year. Virus infection was the most common cause of acquired neutropenia. In patients younger than 12 month old, IgM was higher and IgG was lower than those of control group (all P＜0.05). In the first week of infection 79.7% of patients were found with neutropenia, and drugs that can increase granuloeytes would shorten the recovery time. Conclusions Neutropenia associated infection are more common in male infants and usually caused by viral infection accompanied with immune dysfunction. Used properly and timely, antiviral drugs and antibiotics can shorten the duration of symptoms.%目的 探讨儿童感染相关性中性粒细胞减少症的影响因素及临床特点.方法 收集2010年9月至2011年8月住院并符合中性粒细胞减少症诊断标准的患儿280例,对其病史资料、临床表现、实验室检查、临床治疗及预后进行回顾性分析,并与65名正常对照儿童作血清免疫球蛋白比较.结果 280例中性粒细胞减少症患儿中,3岁以下占78%,男性占62.5%;呼吸道感染占90.7%;全年均可发病,1、3、8月份患儿数量增多.病毒感染是引起儿童继发性中性粒细胞减少的主要原因.<12个月患儿的IgM高于正常对照儿童,IgG低于正常对照儿童,差异均有统计学意义 (P 均<0.05).感染第1周出现粒细胞减少的占79.7%,使用升粒细胞药物可以缩短中性粒细胞恢复至正常的时间.结论 儿童感染相关性中性粒细胞减少症以男性婴幼儿多见,多由病毒感染引起,常伴随免疫功能紊乱.正确使用抗病毒药物及抗生素,及时对症治疗可以缩短其病程.