[1]陈 辉,刘 力,陈 森.儿童全血细胞减少症的临床特征及病因分析[J].医学信息,2020,33(13):99-102,105.[doi:10.3969/j.issn.1006-1959.2020.13.027]
 CHEN Hui,LIU Li,CHEN Sen.Clinical Characteristics and Etiological Analysis of Childhood Pancytopenia[J].Medical Information,2020,33(13):99-102,105.[doi:10.3969/j.issn.1006-1959.2020.13.027]
点击复制

儿童全血细胞减少症的临床特征及病因分析()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年13期
页码:
99-102,105
栏目:
临床研究
出版日期:
2020-07-01

文章信息/Info

Title:
Clinical Characteristics and Etiological Analysis of Childhood Pancytopenia
文章编号:
1006-1959(2020)13-0099-05
作者:
陈 辉刘 力陈 森
(天津市儿童医院血液科,天津 300400)
Author(s):
CHEN HuiLIU LiCHEN Sen
(Department of Hematology,Tianjin Children’s Hospital,Tianjin 300400,China)
关键词:
全血细胞减少症病因临床特征再生障碍性贫血儿童
Keywords:
PancytopeniaEtiologyClinical featuresAplastic anemiaChildren
分类号:
R725.5
DOI:
10.3969/j.issn.1006-1959.2020.13.027
文献标志码:
A
摘要:
目的 分析儿童全血细胞减少症的病因谱,探讨儿童全血细胞减少症的临床特点,以提高临床对该病的诊断。方法 选择2013年1月~2019年12月我院住院的119例全血细胞减少症患者的临床资料,分析其外周血细胞计数检查、血涂片人工显微镜检查、骨髓活组织检查、生化检查、流式细胞检测、病原学检查、影像学检查及基因检查等资料,总结其临床特征及病因。结果 全血细胞减少症最常见的临床特征是苍白、乏力、感染、出血;患者血红蛋白水平为(63.00±16.00)g/L,白细胞计数(2.45±0.57)×109/L,中性粒细胞计数(0.70±0.32)×109/L,血小板计数(43.58±35.24)×109/L,网织红细胞计数(0.043±0.038)×1012/L;44例(36.97%)全血细胞减少症患者为低增生性骨髓,75例(63.03%)为非低增生性骨髓,两者血细胞减少患者的比例比较,差异有统计学意义(P<0.05)。病因学分析显示,再生障碍性贫血(25.21%)是全血细胞减少症最常见的原因,其次是急性白血病(22.69%)及噬血细胞性淋巴组织细胞增生症(9.24%)。结论 全血细胞减少症是临床较常见的血液系统综合征,病因学分类复杂,最常见的病因仍为再生障碍性贫血,但由于诊断技术的进步,基因检测成为先天性骨髓衰竭及遗传代谢病等疾病确诊重要的检测手段,大大丰富了病因谱系,提高了明确诊断率。
Abstract:
Objective To analyze the etiology spectrum of children’s pancytopenia and explore the clinical features of children’s pancytopenia to improve the clinical diagnosis of the disease.Methods The clinical data of 119 patients with pancytopenia hospitalized in our hospital from January 2013 to December 2019 were selected, and their peripheral blood cell count examination, blood smear manual microscopy, bone marrow biopsy, biochemical examination, and flow cytometry were analyzed. Cell detection, etiological examination, imaging examination and genetic examination and other data to summarize its clinical characteristics and causes.Results The most common clinical features of pancytopenia are paleness, fatigue, infection, and bleeding; the patient’s hemoglobin level is (63.00±16.00) g/L , White blood cell count (2.45±0.57)×109/L, neutrophil count (0.70±0.32)×109/L, platelet count (43.58±35.24)×109/L, reticulocyte count (0.043±0.038)×1012/L; 44 cases (36.97%) of patients with pancytopenia had hypoproliferative bone marrow and 75 cases (63.03%) had non-hyperproliferative bone marrow. There was a statistically significant difference in the proportion of patients with cytopenia (P<0.05). Etiological analysis showed that aplastic anemia (25.21%) is the most common cause of pancytopenia, followed by acute leukemia (22.69%) and hematopoietic lymphohistiocytosis (9.24%). Conclusion Pancytopenia is a common clinical hematological syndrome. The etiology is complicated. The most common cause is still aplastic anemia. However, due to the advancement of diagnostic technology, genetic testing has become congenital bone marrow failure and genetic metabolic diseases. The important detection methods for the diagnosis of diseases have greatly enriched the etiology and improved the diagnosis rate.

参考文献/References:

[1]Song XR,Cheng YQ,Su DF,et al.The Sirt1 activator resveratrol improved hematopoiesis in pancytopenia mice induced by irradiation[J].J Pharmacol Sci,2019,140(1):79-85.[2]胡宛如,何莉,张乾忠.与感染相关的全血细胞减少[J].中国实用儿科杂志,2011(10):28-30.[3]Krishnaprasadh D,Kaminecki I,Sechser Perl A,et al.Paroxysmal Nocturnal Hemoglobinuria:Diagnostic Challenges in Pediatric Patient[J].Case Rep Pediatr,2019:4930494.[4]薛露,王玥,李春怀,等.儿童全血细胞减少症354例临床分析[J].中国小儿血液与肿瘤杂志,2014(1):49-52[5]中华医学会血液学分会,中国医师协会血液科医师分会.中国中性粒细胞缺乏伴发热患者抗菌药物临床应用指南(2016年版)[J].中华血液学杂志,2016,37(5):353-359.[6]Jalal MJA,Iqbal KMM,Mahadevan P,et al.Systemic lupus erythematosus presenting as macrophage activation syndrome in an adult male[J].Current Medical Issues,2020,18(1):52.[7]Afridi JK,Younas M,Karim R,et al.Distribution of aplastic anemia in children having new-onset pancytopenia[J].Gomal Journal of Medical Sciences,2017,15(2):59-62.[8]Naseem S,Varma N,Das R,et al.Pediatric patients with bicytopenia/pancytopenia:review of etiologies and clinico-hematological profile at a tertiary center[J].Indian J Pathol Microbiol, 2011,54(1):75-80.[9]杨聪聪.儿童全血细胞减少的临床分析[D].郑州大学,2017.[10]A Rovó,Tichelli A,Dufour C.Diagnosis of acquired aplastic anemia[J].Bone Marrow Transplantation,2012,48(2):162-167.[11]Karthika KV,Mishra P,Pati HP.Inherited Bone Marrow Failure Syndromes[M]//Hematopathology,2019.[12]Bagby G.Recent advances in understanding hematopoiesis in Fanconi Anemia[J].F1000research,2018(7):105.[13]Chaitanya K,Karanam S,Kumar K.Dengue Associated Hemophagocytic Lymphohistiocytosis[J].The Indian Journal of Pediatrics,2020,87(3):237. [14]Jonathan HS,Mark LZ.Ruxolitinib for secondary hemophagocytic lymphohistiocytosis:first case report[J].Hematol Oncol Stem Cell Ther,2019,12(3):166-170.[15]Risma KA,Marsh RA.Hemophagocytic lymphohistiocytosis: clinical presentations and diagnosis[J].The Journal of Allergy,Practice Clinical Immunology,2019,7(3):824-832.[16]Durrani J,Maciejewski JP.Idiopathic aplastic anemia vs hypocellular myelodysplastic syndrome[J].Hematology,2019(1):97-104.[17]Lintao B,Jun L,Zhenxia L,et al.Acute arrest of hematopoiesis induced by infection with Staphylococcus epidermidis following total knee arthroplasty:A case report and literature review[J].Experimental&Therapeutic Medicine,2016,11(3):957-960.

相似文献/References:

[1]王艳妮,杨静秀.宫颈上皮内瘤变病因及诊断的相关研究进展[J].医学信息,2018,31(02):46.[doi:10.3969/j.issn.1006-1959.2018.02.016]
 WANG Yan-ni,YANG Jing-xiu.Research Progress on the Causes and Diagnosis of Cervical Intraepithelial Tumor[J].Medical Information,2018,31(13):46.[doi:10.3969/j.issn.1006-1959.2018.02.016]
[2]许海泉.生酮饮食对不同病因及发作形式儿童难治性癫痫 疗效差异的临床观察[J].医学信息,2018,31(08):88.[doi:10.3969/j.issn.1006-1959.2018.08.027]
 XU Hai-quan.Clinical Observation of the Effect of Ketogenic Diet on the Efficacy of Children with Refractory Epilepsy Due to Different Causes and Attacks[J].Medical Information,2018,31(13):88.[doi:10.3969/j.issn.1006-1959.2018.08.027]
[3]阎晓斌,刘 伟,吕 杰.X线检查临床应用的研究[J].医学信息,2019,32(17):50.[doi:10.3969/j.issn.1006-1959.2019.17.016]
 YAN Xiao-bin,LIU Wei,Lyu Jie.X-ray Examination Clinical Application Research[J].Medical Information,2019,32(13):50.[doi:10.3969/j.issn.1006-1959.2019.17.016]
[4]俞晓晶,王 芳.复发性流产的病因研究[J].医学信息,2020,33(10):34.[doi:10.3969/j.issn.1006-1959.2020.10.010]
 YU Xiao-jing,WANG Fang.Study on the Etiology of Recurrent Spontaneous Miscarriage[J].Medical Information,2020,33(13):34.[doi:10.3969/j.issn.1006-1959.2020.10.010]
[5]赵 丹,段逸山.秦汉时期导引家病因病机探析[J].医学信息,2020,33(11):154.[doi:10.3969/j.issn.1006-1959.2020.11.050]
 ZHAO Dan,DUAN Yi-shan.An Analysis of the Etiology and Pathogenesis of the Daoyinjia in Qin and Han Dynasties[J].Medical Information,2020,33(13):154.[doi:10.3969/j.issn.1006-1959.2020.11.050]
[6]刘 渝,宁金波,易 明,等.新生儿失血性休克的病因及临床特点分析[J].医学信息,2020,33(20):180.[doi:10.3969/j.issn.1006-1959.2020.20.057]
 LIU Yu,NING Jin-bo,YI Ming,et al.Analysis of the Etiology and Clinical Characteristics of Neonatal Hemorrhagic Shock[J].Medical Information,2020,33(13):180.[doi:10.3969/j.issn.1006-1959.2020.20.057]
[7]吴永惠.缺血性中风病的中医药治疗[J].医学信息,2022,35(12):89.[doi:10.3969/j.issn.1006-1959.2022.12.021]
 WU Yong-hui.Traditional Chinese Medicine Treatment of Ischemic Stroke[J].Medical Information,2022,35(13):89.[doi:10.3969/j.issn.1006-1959.2022.12.021]
[8]邵 华.卵巢储备功能下降病因病机及中医药治疗研究进展[J].医学信息,2022,35(14):150.[doi:10.3969/j.issn.1006-1959.2022.14.039]
 SHAO Hua.Research Progress on Etiology, Pathogenesis and Traditional Chinese Medicine Treatment of Ovarian Reserve Decline[J].Medical Information,2022,35(13):150.[doi:10.3969/j.issn.1006-1959.2022.14.039]

更新日期/Last Update: 1900-01-01