Purpura in Childhood Clinical Observation of 60 Cases

小兒紫斑病：60例之臨床觀察

呂志忠(Chu-Chong Lu) ； 吳建仁(Chen-Jen Wu) ； 陳添享(Tien-Sian Chen)

《Acta Paediatrica Sinica》 13卷2期 (1972/06) Pp. 57-67

摘要

著者等將自民國四十九年九月至民國五十九年八月十年間，住院於高雄醫學院小兒科病房而被診斷為類過敏性紫斑病或特發性血小板缺少紫斑病之未滿十五歲病兒各30例計60例，做詳細分析，結果如下：
1.類過敏性紫斑病例之男女比為2；1，而血小板缺少紫斑病例為1;1。
2.三分之二以上之類過敏性紫斑病例之年齡在7歲以上，而三分之二之血小板缺少紫斑病例之年齡在7歲以下。
3.類過敏性紫斑病最易發生於冬季，尤其在二月（6例）時最多，相反地，血小板缺少紫斑病則在夏季，尤於七月時為多。
4.本報告中僅2例類過敏性紫斑病，有個人及家族過敏之病史，而血小板缺少紫斑病病例中，其家族有出血傾向者共有6例。
5.大部份(96.6%)類過敏性紫斑病例均有病前感染或發燒，而血小板缺少紫斑病例則僅有三分之一病例有之。
6.類過敏性紫斑病之初發主要臨床症狀為皮膚出血，胃腸，關節及腎臟受侵犯之症狀，而血小板缺少紫斑病則以出血傾向為唯一主要症狀。
7.實驗診斷檢查中，除血小板缺少紫斑病有末稍血小板缺少及出血時間延長外，其他均在正常範圍。
8.46.6%彩之過敏性紫斑病及166%之血小板缺少紫斑病，有一次或二次以上之再發現象。
9.本報告60例中，經對症治療，輸血及腎上腺賀爾蒙治療，除血小板缺少紫斑病中2例死亡外，均有良好效果。
10.著者等並引用文獻做比較與討論。

並列摘要

Sixty patients with purpura below 15 years of age were diagnosed as anaphylactoid purpura (AP) and idiopathic thrombocytopenic purpura (ITP), 30 cases each, and were hospitalized at the pediatric ward of Kaohsiung Medical College Hospital during the ten-year period from September 1960 to August .1970. The results of clinical analysis are summarized as follows:
The sex ratio male/female was 2:1 for AP and 1:1 for ITP. Over two thirds of AP patients were 7 years or older while two thirds of ITP patients were 7 years or younger. AP occurred most frequently in winter with the highest monthly incidence (6 cases) in February. Meanwhile ITP mostly in summer season especially in July. The initial main symptoms, and signs of the patients with AF were hemorrhagic skin rashes, GI symptoms, joint and renal invo7vements while in ITP hemorrhagic tendency seemed to be the only essential symptom. About one half (46.6%) of patients with AP and 16.6% of patients with ITP had one or more recurrences and 2 in ITP series died. Most of the patients recovered favorably after symptomatic treatments, blood transfusion and/or steroid therapy.