- 期刊
Thrombocytosis in Children at One Medical Center of Southern Taiwan
南方灣某醫學中心病童血小板過高症之研究
摘要
血小板過高症在孩童經常是沒有症狀的,常常是在血液常規檢查時發現有血小板過高之情形.而導致血小板過高常見的原因,包括有感染,外傷,血液疾病,早產,腎臟病及慢性發炎等等.在此篇報告中,我們研究了從1996年10月至1997年11月高雄醫學院附設醫院小兒科的住院病人,以瞭解南臺灣住入高雄醫學院附設醫院病童之血小板過高症之病因及發生率.在此期間,共有2910位病童住進高雄醫學院小兒科,其中有220位病人在其住院期間被發現有血小板過高症（血小板數目大於50萬/mm^3），包含127位男性及93位女性。在血液常規檢查中，血小板過高的發生率有7.6%。而與血小板過高症相關的原因包括感染(49.5%)，川崎症(6.4%)，脾臟切除(7.8%)，血液疾病(3.7%)，惡性腫瘤(3.2%)，早產(3.2%)，緩緩破壞及手術(4.5%)，其他慢性發炎(1.8%)，骨髓抑制後的恢復(1.3%)，免疫系統之疾病(2.2%)，及原發性血小板過高症(0.5%)。合併多重原因者則占9.0%。因感染及川崎症而有血小板過高症的病童，大部分年齡都小於2歲。感染疾病中，最常見的診斷是呼吸道感染，共占61.1%。有29位元病童(13.2%)其血小板數目大於80萬/mm3，其中有12位是患有感染疾病。所有病童皆未發生血栓併發症。
並列摘要
Thrombocytosis in children is common, but usually without symptoms. The causes of thrombocytosis in children are considered to be mostly due to infection, trauma, surgery, blood disease, prematurity, renal disease and chronic inflammation. To evaluate the incidence and etiology of thrombocytosis of the hospitalized patients, patients who were admitted to the Pediatric Department of Kaohsiung Medical College Hospital (KMCH) from October 1996 to November 1997 were studied. There were 2910 cases studied and 220 cases (127 male and 93 female) had thrombocytosis (≥500×10^9/L) with a rate of 7.6%. The causes of thrombocytosis are infections (49.5%), Kawasaki disease (6.4%), postsplenectomy (7.8%), blood diseases (3.7%), malignancies (3.2%), renal disorders (3.2%), prematurity (3.2%), tissue damage (4.5%), chronic inflammation (1.8%), recovery from marrow suppression (1.3%), immunologic disturbances (2.2%), essential thrombocythemia (0.5%), and miscellaneous factors (3.7%). Thrombocytosis associated with multiple, simultaneous causative factors was found in 9.0% of these cases. Thrombocytosis secondary to infectious diseases or Kawasaki disease was significantly more common in children under 2 years old. The most commonly associated infectious disease was respiratory tract infection (61.1%). There were 29 children (13.2%) presenting a platelet count of more than 800,000/mm^3. However, no thrombotic complications were seen in any of the children. By far, the major cause of thrombocytosis in our cases was reactive in character. Most of the thrombocytosis cases were due to infections, inflammatory diseases, or Kawasaki disease.