本文選題：粒細胞減少癥　切入點：幼兒急疹　出處：《重慶醫(yī)科大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的 分析幼兒急疹合并中性粒細胞減少癥的臨床特點，為臨床診治提供參考依據(jù)。 方法 1.回顧性分析2010年1月至2011年6月于重慶醫(yī)科大學附屬兒童醫(yī)院內科住院治療的40例幼兒急疹合并中性粒細胞減少癥患兒的臨床資料，對照組為隨機抽取的40例上呼吸道感染合并中性粒細胞減少癥患兒，年齡分布與研究組相當。 2.運用SPSS19.0分析整理數(shù)據(jù)，使用χ2檢驗、t檢驗及方差分析分析相關數(shù)據(jù)，P0.05有統(tǒng)計學意義。 結果 1.研究組與對照組之間男女比例及年齡分布均無顯著性差異（P0.05）。研究組男24例，女16例，1歲20例，1-3歲20例。 2.研究組與對照組發(fā)病季節(jié)，無顯著性差異，均以春、夏季發(fā)病居多。 3.研究組與對照組發(fā)熱程度，無顯著性差異，，均以高熱居多。研究組患兒皮疹均于熱退當天或熱退1天后出現(xiàn)。 4.研究組中各年齡組之間及性別之間發(fā)熱持續(xù)時間無顯著性差異（P0.05）。研究組與對照組發(fā)熱持續(xù)時間無顯著性差異(P0.05),研究組平均發(fā)熱持續(xù)時間為3.05天，對照組為3.25天。 5.初始時間：從開始發(fā)熱到病程中首次發(fā)現(xiàn)白細胞計數(shù)（white-blood-cell count, WBC）及中性粒細胞絕對值（AbsoluteNeutrophil count, ANC）降低的時間。持續(xù)時間：從發(fā)現(xiàn)WBC及ANC減少至其降至最低的時間。 研究組與對照組的初始時間比較有顯著性差異（P0.05）。研究組WBC及ANC降低均于發(fā)熱1-2天后出現(xiàn)，平均1.27天，對照組于發(fā)熱1-5天后出現(xiàn)，平均2.35天。研究組與對照組的持續(xù)時間無顯著性差異（P0.05）,均于0-2天。 6.研究組與對照組在WBC及ANC降低程度上無顯著性差異(P0.05)。 7.研究組與對照組在WBC恢復時間上有顯著性差異（P0.05），研究組WBC平均恢復時間3.05天，對照組3.65天。研究組患兒出院時ANC尚未完全恢復至正常水平（平均住院日為4.8天），但較入院時明顯上升，對照組ANC平均恢復時間為4.40天。兩組ANC恢復至正常時間均較WBC恢復時間晚。 8.研究組中是否使用藥物升白細胞治療，在WBC恢復時間上無顯著性差異（P0.05），在予升白細胞藥物治療的病例中，不同治療方案在WBC恢復時間上均無顯著性差異（P0.05）。 結論 幼兒急疹合并中性粒細胞減少癥患兒以小于3歲男性患兒多見，好發(fā)于夏季，多為高熱，皮疹多于熱退當天或熱退1天后出現(xiàn)。WBC及ANC水平降低于發(fā)熱1-2天后出現(xiàn)。用藥與否與WBC恢復時間無明顯相關性。ANC恢復時間較WBC恢復時間稍慢。研究組WBC恢復時間短，說明幼兒急疹合并中性粒細胞減少癥患兒預后好。
[Abstract]:objective
Analysis of the clinical characteristics of exanthema subitum with neutropenia, provides the reference for the clinical diagnosis and treatment.
Method
1. January 2010 to June 2011 were retrospectively analyzed in 40 cases of exanthema subitum children's Hospital Affiliated to Medical University Of Chongqing medical hospital treatment combined with neutropenia in children with clinical data, control group with neutropenia in 40 children with upper respiratory tract infection were randomly selected, age distribution and research group.
2. the data were analyzed by SPSS19.0 analysis, using the chi square 2 test, t test and analysis of variance analysis related data, P0.05 had statistical significance.
Result
1. there were no significant differences in male and female ratio and age distribution between the study group and the control group (P0.05). There were 24 male, 16 female, 1 year old and 20 cases and 20 cases 1-3 years old in the study group.
2. the onset season of the study group and the control group had no significant difference, all in spring and in summer.
3. the fever degree of the study group and the control group had no significant difference, all with high fever. The rash of the children in the study group appeared on the day of hot retreat or 1 days after the heat retreat.
4., there was no significant difference in the duration of fever between the different age groups and the gender in the study group (P0.05). There was no significant difference in the duration of fever between the study group and the control group (P0.05), the average duration of fever in the study group was 3.05 days, and the control group was 3.25 days.
5., the initial time: from the onset of fever to the first course of disease, the time of white-blood-cell count (WBC) and AbsoluteNeutrophil count (ANC) decrease. Duration: from the discovery of WBC and ANC to the lowest time.
The initial time of study group and control group had significant difference (P0.05). The study group WBC and ANC decreased both appeared in the fever for 1-2 days, an average of 1.27 days, in the control group after 1-5 days of fever, an average of 2.35 days. There was no significant difference between the duration of the study group and the control group (P0.05), both in 0-2 days.
6. there was no significant difference in the reduction of WBC and ANC between the study group and the control group (P0.05).
7. the study group and the control group there were significant differences in WBC recovery time (P0.05), the study group WBC the average recovery time of 3.05 days, the control group for 3.65 days. The children study group was ANC has not yet fully recovered to the normal level (the average duration of hospitalization was 4.8 days), but were significantly higher than those of control group were increased, ANC the average recovery time was 4.40 days. The two group ANC returned to normal time than WBC recovery time is late.
8. in the study group, there was no significant difference in the recovery time of WBC between the two groups (P0.05). There was no significant difference in the recovery time of WBC between different treatment regimens (P0.05).
conclusion
Exanthema subitum with neutropenia in children less than 3 year old male with rare, occur in the summer, more than high fever, rash or fever fever the day after 1 days of.WBC and ANC decreased in 1-2 days after medication and fever. And the recovery time of WBC was not related to.ANC recovery time WBC recovery time is slow. The study group WBC recovery time is short, that exanthema subitum with neutropenia in children with a good prognosis.

【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.1

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