儿童及青少年巨幼细胞性贫血病因及临床特点变化分析
Analysis of etiology and clinical characteristics of children and adolescents with megaloblastic anemia
谷文鑫 1李春怀 1王玥 1刘爽爽 1常纯 1姜昊旻 1薛露1
作者信息
- 1. 130021 长春,吉林大学第一医院小儿血液科
- 折叠
摘要
目的 探讨及分析近年来儿童巨幼细胞性贫血(MA)的病因及临床特点的变化.方法 对本中心13例MA患儿的临床资料进行回顾性分析,总结及探讨病因构成及临床特点的变化.结果 病因方面,13例患儿中10例处于青春期生长过快(占77％),9例饮食结构不合理(占69％).临床特点突出表现为发病年龄明显滞后,中位年龄14岁,最小年龄6岁;就诊原因多为急性感染和出血,而早期的贫血、巩膜黄染、神经系统损害症状并未引起重视;外周血象改变明显,红系改变为著,均为大细胞性贫血,其中7例(54％)为重度贫血,8例(62％)全血细胞减少.骨髓流式细胞学突出改变为幼红细胞表面CD71和CD36表达减低.结论 儿童MA的病因及临床特点近年来逐渐发生变化,早期易被漏诊和误诊,需引起儿科医生重新重视.
Abstract
Objective To investigate and analyze the changes of etiology and clinical characteristics of megaloblastic anemia in children in recent years.Methods Clinical data of 13 children with megaloblastic anemia in our center were analyzed retrospectively,changes of etiology and clinical characteristics were summarized and discussed.Results In terms of etiology,10 cases(77％)of the 13 children were in puberty with rapid growth,and 9 cases(69％)had unbalanced diet.The most prominent change in clinical characteristics is the age of onset peak of the children delayed significantly,with a median age of 14 years old and a minimum age of 6 years old.Acute infection and bleeding were the main reasons for most children to seek medical advice.However,early anemia,jaundice and nervous system damage did not attract attention.The changes of complete blood counts were obvious and the changes of red blood cell were obvious.All of them were macrocytic anemia and 7 cases(54％)were severe anemia,8 cases(62％)were pancytopenia.The prominent change of bone marrow flow cytometry was reduced expression of CD71 and CD36 on surface of erythrocytes.Conclusions The etiology and clinical characteristics of megaloblastic anemia in children have changed gradually in recent years,and it is easy to be missed and misdiagnosed in the early stage,pediatricians should pay more attention to it.
关键词
巨幼细胞性贫血/全血细胞减少/病因/发病高峰年龄段/神经系统损害Key words
Megaloblastic anemia/Pancytopenia/Etiology/Onset peak age/Neurological damage引用本文复制引用
基金项目
吉林大学第一医院人才储备项目(2019)()
出版年
2024
NETL
NSTL
万方数据