检验医学 ›› 2012, Vol. 27 ›› Issue (5): 389-392.

• 微生物学检验论著 • 上一篇    下一篇

巨细胞病毒感染与特发性血小板减少性紫癜的关系探讨

陈鹄1,肖建华2   

  1. 1. 南华大学第二附属医院检验科,湖南 衡阳 421001;2.南华大学病原微生物教研室,湖南 衡阳 421001
  • 收稿日期:2012-03-16 修回日期:2012-03-08 出版日期:2012-05-30 发布日期:2012-05-10
  • 作者简介:陈 鹄,女,1969生,硕士,副主任技师,主要从事临床检验与免疫学研究。

Relationship investigation on idiopathic thrombocytopenic purpura with cytomegalovirus infection

  1. 1. Department of Clinical Laboratory, the Second Hospital of Nanhua University, Hunan Hengyang 421001, China; 2. Institute of Pathogenic Biology, Nanhua University, Hunan Hengyang 421001, China
  • Received:2012-03-16 Revised:2012-03-08 Online:2012-05-30 Published:2012-05-10

摘要: 目的 探讨巨细胞病毒(CMV)感染与特发性血小板减少性紫癜(ITP)的关系,有CMV感染的ITP的临床特征及CMV对ITP患者治疗与疗效的影响。方法 检测153例ITP患者外周血白细胞CMV PP65抗原。以CMV PP65抗原阳性者作为CMV感染组(31例);以CMV PP65抗原阴性者作为阴性对照组(35例);以102名健康体检者作为正常对照组。采用细胞形态学及统计学等方法分析比较3个调查组的一般资料、临床表现、实验室检查及治疗效果。结果 ITP患者CMV感染率为20.3%(31/15);CMV感染组平均年龄仅为20±12,且更易发生皮肤出血;CMV感染组骨髓巨核细胞总数均值少于阴性对照组,且巨核细胞成熟停滞阶段更早;CMV感染组的ITP单纯糖皮质激素治疗总有效率为35.5%,若伍用更昔洛韦(GCV),可提高总有效率至85.0%。 结论 CMV可能是诱发ITP的原因之一; CMV感染的ITP患者更易发生皮肤出血,骨髓巨核细胞代偿增生性反应减低,且成熟停滞阶段更早;CMV感染的ITP患者单纯用糖皮质激素疗效较差,GCV可提高治疗总有效率。

关键词: 巨细胞病毒, 特发性血小板减少性紫癜, 临床特征, 巨核细胞, 疗效

Abstract: Objective To study the relationship between the idiopathic thrombocytopenic purpura(ITP)and the infection of cytomegalovirus(CMV), the clinical symptom of ITP,and the curative effect of ITP patients with CMV infection.   Methods The 153 cases of ITP in-patients in hospital were studied. All patients were measured the antigens of CMV PP65 of white blood cell in peripheral blood. The general data, clinical manifestation, laboratory examination and treatments of 3 investigated groups were analyzed by cytomorphology and statistics methods. Results The infective rate of CMV in ITP patients was 20.3%.The average age of ITP patients with CMV infection was 20.03±11.7. The ITP patients with CMV infection were inclined to suffer from skin hemorrhage. In the ITP patients with CMV infection, the average of marrow megacaryocyte numbers was lower than that of the negative controls,and megakaryocytic maturation lag was earlier. The general effective ratio in ITP patients with CMV infection treated with glucocorticoids was 35.5%. The total effective ratio of combined therapy,as glucocorticoids and ganciclovir (GCV), in ITP patients with CMV infection was 85.0%. Conclusions CMV may be one of the viruses causing ITP disease. The ITP patients with CMV infection are inclined to occur skin hemorrhage. The marrow megacaryocyte productive reaction of ITP patients with CMV infection was inferior to that of negative controls,and megakaryocytic maturation lag is earlier. The curative effect of glucocorticoids is low. The combined therapy of glucocorticoids and GCV could improve curative effect.

Key words: Cytomegalovirus, Idiopathic thrombocytopenic purpura, Clinical characteristic, Megacaryocyte, Curative effect