临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (12): 930-.doi: 10.3969/j.issn.1000-3606.2016.12.012

• 综合报道 • 上一篇    下一篇

儿童自身免疫性溶血性贫血29 例临床特点和治疗分析

解飞, 周霖, 蔡斌, 雷蕾, 蒋瑾瑾, 陈若华   

  1. 第二军医大学附属长海医院(上海 200433)
  • 收稿日期:2016-12-15 出版日期:2016-12-15 发布日期:2016-12-15
  • 通讯作者: 陈若华 E-mail:rhchen1964@sohu.com

Clinical features and treatment of autoimmune hemolytic anemia in 29 children

XIE Fei, ZHOU Lin, CAI Bin, LEI Lei, JIANG Jinjin, CHEN Ruohua   

  1. Department of Pediatrics, Changhai Hospital Affiliated to The Second Military Medical University, Shanghai 200433 , China
  • Received:2016-12-15 Online:2016-12-15 Published:2016-12-15

摘要: 目的 探讨自身免疫性溶血性贫血的病因及治疗。 方法 回顾分析2013年1月至2015年12月收治的29例 自身免疫性溶血性贫血患儿的临床资料。 结果 29例患儿中,原发性10例、继发性19例,其中11例发生于感染后。主要 临床表现为面色苍白、黄疸、尿色加深及肝脾肿大,21例Coombs试验阳性。29例患儿中,肾上腺皮质激素治疗反应良好 22例;治疗效果不佳7例,在联合丙种球蛋白治疗后效果良好。 结论 自身免疫性溶血性贫血治疗首选药物为肾上腺皮质 激素,丙种球蛋白可提高疗效。

Abstract:  Objective To analyze the etiology and treatment of autoimmune hemolytic anemia. Methods The clinical data of 29 children with autoimmune hemolytic anemia during January 2013 to December 2015 were retrospectively analyzed. Results In 29 children, 10 cases were idiopathic 19 cases were secondary and 11 cases occurred after infections. The main clinical manifestations were pallor, jaundice, dark urine, and hepatosplenomegaly. 21 cases were Coombs test positive. In 29 children, 22 cases had a good response to adrenocortical hormone therapy while in 7 cases which had not response to adrenocortical hormone, good efficacy was achived after combined with the gamma globulin treatment. Conclusions The first line drug for autoimmune hemolytic anemia treatment is adrenocortical hormone. The gamma globulin can improve the efficacy.