A Clinical Study of Childhood Idiopathic Thrombocytopenic Purpura

孩童特發性血小板減少性紫瘢症為一常見之疾病。吾人搜集自民國50年至71年間於臺大醫院小兒科診斷為此症之患者共422例。其中除去80例因追蹤不足，另32例為其他醫院轉診者，其餘可分為急性型232例佔74.8%，慢性型69例佔22.3%及慢性再發型9例佔2.9%。男女比例約相等，然慢性型以女性居多。好發年齡為學齡前，佔67%之患者為小於6歲。此症較易在夏、秋二季發現。初診時血小板數目之分布於急性或慢性並無明顯差異。臨床表徵則以皮膚之出血點或紫瘢為最常見，佔94.1%，次為流鼻血及粘膜出血。顱內出血者僅佔1.2%。約42%之患者有明顯之先行性感染病史，諸如上呼吸道感染，發燒，德國麻疹，麻疹等。急性型患者中，約84.9%於6週內便完全恢復正常。慢性型中則有23例接受脾臟切除手術，有良好反應者佔56.2%，其中尤以女性且年齡較長者為佳，此乃二點與預後有關之因素。本系列有31例為嬰兒期患者，其中則男嬰罹患率較高，多為急性型（佔89.3%）且恢復迅速。

關鍵字

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並列摘要

Four hundred and twenty-two patients were diagnosed as idiopathic thrombocytopenic purpura (ITP) in the Pediatric Department of the National Taiwan University Hospital (NTUH) from January 1961 to December 1982. After exclusion of 80 inadequate follow-up cases, and 32 known chronic (referred) cases on their first visit to this hospital, 232 cases (74.8%) were described as acute form, 69 cases (22.3%) were chronic form and nine cases (2.9%) were categorized as chronic recurrent form. The whole series showed no sex predilection, but there was some female predominance in the chronic form. Sixty-seven percent of our cases occurred before six years of age. The disease occurred more frequently in summer and autumn. Distribution of initial platelet counts was almost the same in both acute and chronic forms. Clinical manifestations were petechiae and/or ecchymosis over the skin (94.1%), epistaxis (39.3%), oral mucosal bleeding (31.3%), G-I bleeding (7.8%) and hematuria (3.8%). Intracranial hemorrhage occurred in 1.2% of the cases. Forty-two per cent of the cases had obvious antecedent disease such as upper respiratory infection, fever, rubella, measles, et cetera. Of the acute form, 84.9% of the cases recovered within six weeks. In chronic cases, 23 cases received splenectomy, with an overall response rate of 56.5%. Females had twice the success rate of males. There was no operation mortality. Female sex and older age were the predictable factors for better response in this series.

並列關鍵字

thrombocytopenic purpura ； acute ； chronic ； idiopathic

國際替代計量

A Clinical Study of Childhood Idiopathic Thrombocytopenic Purpura

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