摘要
目的分析中国人群胎儿/新生儿同种免疫性血小板减少症(fetal neonatal alloimmune thrombocytopenia,FNAIT)的发病情况、临床特征、死亡高危因素,总结中国人群FNAIT流行病学特点,为制定防治策略提供支持。方法检索PubMed、中国生物医学文献数据库、中国知网、万方、维普数据库和百度学术收录的1985年1月~2021年1月发表的关于中国人群新生儿同种免疫性血小板减少症的个案病例报道,根据纳入和排除标准对文献进行筛选,使用SPSS 21.0软件对文献数据进行回顾性分析。结果共纳入21篇文献,包括36例患儿,其中27例患儿血小板抗体阳性,9例患儿在排除其他血小板减少性疾病后,根据临床症状及血小板数量确诊。患儿中男性20例,女性14例(缺失2例数据),发病年龄中位数为1天。患儿母亲中,单胎33例,双胎3例;初产妇17例,经产妇19例;血小板计数均正常。患儿血小板计数中位数27.5×10^(9)/L;临床主要表现为瘀点瘀斑、消化系统出血及颅内出血;经过免疫球蛋白、糖皮质激素及输血治疗,死亡/胎死宫内2例(5.9%);经Logistic回归分析显示,胎儿母亲的孕产史、胎儿血小板数量及胎儿消化道出血及颅内出血症状不构成影响患儿是否存活的危险因素。结论我国的新生儿同种免疫性血小板减少症发病率较低,患儿经常规治疗存活率较高,不推荐对孕产妇进行常规血小板抗体筛查。
Objective To analyze the incidence,clinical features,and risk factors for death of neonatal alloimmune thrombocytopenia(FNAIT)in Chinese population,in order to summarize the epidemiological characteristics of FNAIT in Chinese population and provide support for the development of prevention and control strategies.Methods We retrieved from Medline,PubMed,CBM,CNKI,Wanfang Database,VIP Database and Baidu Academic Search Engine for case reports of FNAIT published from January 1985 to January 2021.The literature was screened according to the inclusion and exclusion criteria,and the literature data was retrospectively analyzed using SPSS 21.0 software..Results A total of 21 studies were included,involving 36 children.27 children had positive platelet antibodies,and 9 cases were diagnosed by clinical symptoms and platelet count after exclusion of other thrombocytopenia diseases.Among the children,20 cases were males and 14 cases were females(2 cases were missing),and the median age of onset was 1 day.There were single fetus in 33 cases and twins in 3 cases.The platelet count of mothers was normal with 17 primiparas and 19 multiparas.The median platelet count in the children was 27.5×10^(9)/L,and the clinical manifestations were petechiae,gastrointestinal bleeding and intracranial hemorrhage.After immunoglobulin,glucocorticoid therapy and blood transfusion,2 cases died or died intrauterine(5.9%).Logistic regression analysis showed that maternal pregnancy and birth history,fetal platelet count,fetal gastrointestinal bleeding and intracranial hemorrhage did not be the risk factors affecting the prognosis of children.Conclusion In China,the incidence of FNAIT is low,and the prognosis of neonatal patients is relatively high after conventional treatment.Routine platelet antibody screening for pregnant women is not recommended.
作者
马铭梓
王秋实
于洋
MA Ming-zi;WANG Qiu-shi;YU Yang(Medical school of Chinese PLA,Beijing 100853)
出处
《临床输血与检验》
CAS
2021年第5期585-592,共8页
Journal of Clinical Transfusion and Laboratory Medicine
基金
辽宁省科学技术计划项目(No.2018225088)资助。
关键词
中国人群
新生儿同种免疫性血小板减少症
文献分析
Chinese population
Fetal neonatal alloimmune thrombocytopenia
Literature analysis
