关键词: 儿童免疫性血小板减少症, 丙种球蛋白, 对症治疗, 抗核抗体, 抗核抗体谱

Abstract: Objective To explore the characteristics, the effect of different treatments, and the role of antinuclear antibody/antinuclear antibody spectrum (ANA/ANAs) of immune thrombocytopenia (ITP) in children. Methods We retrospectively analyzed the characteristics of 204 children with new-onset ITP in the First Affiliated Hospital of Harbin Medical University from February 2017 to January 2019. Among them, 135 cases who could be followed up were classified according to intravenous immunoglobulin（IVIg）or symptomatic treatment, ANA/ ANAs positive or negative. The basic characteristics and treatment response of different groups were compared. Results The initial platelet count of the patients treated with IVIg was lower than that in symptomatic treatment group, and the platelet elevation, complete response rate (CR), overall response (CR+R) rate and ANA/ANAs positive rate were higher than those in the symptomatic treatment group, but there was no difference in the chronic rate. The initial platelet count of patients with ANA/ANAs positive was lower than that of negative patients. On the 5th day after admission, the platelet elevation and CR rate of patients with ANA/ ANAs positive treated with IVIg were lower than those of negative patients. The time of platelet elevation to normal in ANA/ANAs positive patients was longer. There was no difference between the CR+R rate and chronic rate. Conclusion In the treatment of children ITP,IVIg can rapidly increase platelets, but there is no advantage in long-term response. The treatment response of ANA/ANAs positive patients is worse than that of negative patients, so it is necessary to take more active treatment in the early stage.

Key words: Immune thrombocytopenia in children, IVIg, Symptomatic treatment, ANA, ANAs