摘要
目的探讨人细小病毒B19(简称B19)感染相关过敏性紫癜患儿临床特征及治疗方法。方法采用巢式PCR和ELISA法对75例过敏性紫癜患儿进行B19-DNA及IgM检测;对B19-IgM阳性患儿进行临床特征分析,比较激素和丙种球蛋白的治疗效果。结果1.病例组75例中B19-DNA阳性26例(34.67%),B19-IgM阳性21例(28.0%);健康对照组32例中B19-DNA、B19-IgM阳性各1例(3.13%),两组B19-DNA和B19-IgM阳性率差异均有显著性(P均<0.01)。2.过敏性紫癜患儿临床各型间B19-DNA及B19-IgM阳性率均无显著差异(P均>0.05),B19-IgM阳性患儿中混合型所占比例最大,皮肤型次之。3.激素组和丙种球蛋白组治疗关节肿痛、胃肠道症状、肾损害方面差异均无显著性,但在皮疹消退方面,后者疗效优于前者。4.激素组B19-DNA清除率25.0%,丙种球蛋白组B19-DNA清除率为81.82%,两组清除率具有显著差异(P<0.05)。结论B19可能是导致过敏性紫癜的主要病原体之一;B19感染相关过敏性紫癜患儿临床表现具有多样性;对过敏性紫癜患儿应进行B19病毒检测;应用丙种球蛋白治疗B19感染相关过敏性紫癜可取得良好疗效。
Objective To study the clinical features and treatment of human parvovirus B19 infection associated Henoeh Schonlcin purpura. Methods Nested PCR and ELISA were used to detect serum B19 - DNA and B19 - IgM in 75 children with Henoch - Schonlein purpura. The elinical features of patients with positive B19 - IgM were analyzed and therapeutical effects of horn/one and gamma globulin were compared. B19 - DNA clearance after treatment by 2 methods was detected. Results 1. In the study group, 26 （34.67 % ） patients were positive for B19 - DNA and 21 （28.0%）were positive for B19 IgM. In the healthy control group, 1 （3.13%）eases was positive for B19-DNA and B19- IgM,repectivdy. There was significant difference between the positive rates of B19 DNA and IgM in the study group and those in the healthy control group（ P〈 0.01 ）. 2. There was no difference in the positive rates of B19- DNA and IgM among each type of the study group （ P 〉0.05）. Among B19 positive cases, the number of patients with mixed type was the most and that of patients with dermal type was the second. 3. There was no difference in relief of joint pain, gastrointestinal tract symptom and kidney lesion between hormone group and gamma globulin group （ P 〉0.05）, but the latter was superior to the former in extinction of exanthem. 4. B19 DNA clearance of hormone group was 25.0 %, that of gamma globulin group was 81.82 %, and there was significant difference between 2 groups（P〈0.05）. Conclusions 1. There is a close relationship between B19 and children＇s Henoch-Schonlein purpura,and B19 might be one of the main pathogenic agents which lead to Henoch-Schonlein purpura, Children with B19 infection associated Henoch-Schonlein purpura have clinical diversities. B19 should be detected in children with Henoeh Schonlcin purpura. Effect of applying gamma globulin to treating B19 infection associated Henoch - Shonlein purpura is desirablc.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2006年第9期525-526,共2页
Journal of Applied Clinical Pediatrics
基金
国家自然科学基金项目资助(39870021)
