探讨婴儿期特发性血小板减少性紫癜(ITP)的临床特点。

收集2006年1月至2011年12月在本院儿科住院的婴幼儿ITP患儿130例为研究对象，均符合ITP的诊断标准。按照年龄段，将其分为婴儿组(n＝67，≤12个月龄)和幼儿组(n＝63，1～3岁)。两组患儿的性别、年龄等比较，差异无统计学意义(P>0.05)(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与之签署临床研究知情同意书)。采用回顾性分析法对两组ITP患儿的性别构成、发病诱因、入院时血小板(PLT)计数、临床表现、疗效及转归等进行统计学分析。

婴儿组和幼儿组的男、女患儿比例比较，差异无统计学意义(U＝0.6499，P>0.05)。婴儿组于发病前4周内存在前驱感染者占40.29%(27/67)，幼儿组占60.32%(38/63)，两组比较，差异有统计学意义(U＝2.2827，P<0.05)；婴儿组于发病前4周内存在疫苗接种史者为23.88% (16/67)，幼儿组为0(0/63)，两组比较，差异有统计学意义(U＝4.2909，P<0.01)。婴儿组患儿入院时中位PLT计数均低于幼儿组，两者比较(8×10⁹/L vs. 13×10⁹/L)，差异有统计学意义(t＝2.864，P<0.01)。婴儿组ITP多导致皮肤出血，出血程度较轻；而幼儿组则多导致皮肤黏膜出血，或皮肤与黏膜混合出血，出血程度较重，但其他出血部位婴儿组多于幼儿组(U＝2.3238，P<0.05)。婴儿组疗效(完全缓解率＋有效率)为100.00%，无一例进展至慢性ITP；幼儿组疗效(完全缓解率＋有效率)为92.06%(58/63)，11例(17.46%)进展至慢性ITP。

婴儿期ITP的发病诱因为婴儿期疫苗接种史，临床常规ITP治疗对婴儿期ITP疗效较好，起效快，不易进展至慢性ITP。

To analysis clinical characteristics of infantile idiopathic thrombocytopenic purpura (ITP).

From Jaunary 2006 to December 2011, a total of 130 ITP patients (including 67 infants and 63 children) were enrolled in this study. They were divided into two groups according to their age, infant group (n=67) and young children group (n=63). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangxi Baise Maternal and Child Health-Care Hospital. Informed consent was obtained from all participates' parents. Clinical features of gender distribution, predisposing factors, clinical manifestations, blood test on admission, treatment effect and outcome were retrospectively reviewed.

No significant difference of gender distribution in two groups were found (U=0.6499, P>0.05). Prodromal infections within 4 weeks before the onset were found in 40.29% (27/67) of infant group and 60.32% (38/63) of young children group (U=2.2827, P<0.05). The history of vaccination within 4 weeks were found in 23.88% (16/67) of infant group, and zero (0.00) of young children group (U=4.2909, P<0.01). The median of platelet counts on admission in infant group (8×10⁹/L) were significant lower than that in young children group (13×10⁹/L) (t=2.864, P<0.01). Clinical presentation of infant group were skin bleeding or mile hemorrhage, young children group showed mucosal bleeding or mixed bleeding of skin and mucous membrane and severe hemorrhage. Bleeding in other sites was observed predominantly in infant group compared with that in young children group (U= 2.3238, P<0.05). The rates of therapeutic effects (complete remission + valid) in infant group was 100.00% with no chronic cases, and 92.06% (58/63) in young children group, 11 cases (17.46%) were developed into chronic ITP in young children group.

The history of vaccination was the crux of infantile ITP. Infantile ITP has good efficacy, rapid response, lower susceptibility and so on.