儿童原发免疫性血小板减少症红外热图特征初探(1)
〔摘要〕 目的 应用红外热成像技术观察儿童原发免疫性血小板减少症(immune thrombocytopenia，ITP)与健康儿童的红外热图差异，为ITP儿童的临床诊断与疗效评价提供新的可视化指标。方法 采集22例ITP患儿(ITP组)与11例健康儿童(对照组)的红外热图，对躯干、四肢近段区域的非均一性进行统计学分析，并对躯干三焦、双手掌、头面区域与躯干部位相对热态差值(△t)进行统计学分析。结果 ITP组的非均一性明显大于对照组，差异具有统计学意义(t=3.432，P<0.01);ITP组的△t手掌明显大于对照组，差异具有统计学意义(t=3.438，P<0.01);ITP组的△t脊柱区小于对照组，差异具有统计学意义(t=-2.239，P<0.05);健康组三焦△t排序呈现为：△t上焦<△t中焦<△t下焦，ITP组三焦△t排序为：△t上焦>△t中焦>△t下焦。结论 ITP儿童较健康儿童躯干及四肢近段部位“均一性”差，且手掌、脊柱区域温度存在明显差异，红外热成像技术可为ITP儿童的病情评估及疗效评价提供新的方法。
〔关键词〕 原发免疫性血小板减少症;儿童;红外热成像;非均一性;相对热态差值
〔中图分类号〕R259;R558+.2 〔文献标志码〕A 〔文章编号〕doi：10.3969/j.issn.1674-070X.2020.05.014
〔Abstract〕 Objective To observe the difference of infrared thermal imaging between children with primary immune thrombocytopenia (ITP) and healthy children by using infrared thermal imaging technology， so as to provide a new visual index for clinical diagnosis and treatment of ITP children and clinical efficacy evaluation. Methods The infrared charts of 22 ITP children (ITP group) and 11 healthy children (control group) were collected， and the non-uniformity of the trunk area and limb proximal area were statistically analyzed， and the relative thermal calorific value data (△t) of the differences between the trunk sanjiao area， palms area， face area and the trunk area were statistically analyzed. Results The non-uniformity of ITP group was significantly greater than that of the control group， and the difference was statistically significant (t=3.432， P<0.01). The △t of palms area in the ITP group was significantly larger than those of the control group， and the difference was statistically significant (t=3.438， P<0.01). The △t of spinal region in the ITP group was smaller than that in the control group， and the difference was statistically significant (t=-2.239， P<0.05). The △t of Sanjiao in the healthy group sequenced： upper jiao < middle jiao < lower jiao. And the ITP group sequenced： upper jiao > middle jiao > lower jiao. Conclusion Compared with healthy children， children with ITP have poor uniformity in trunk area and proximal limbs area， and have significant differences in palms area and spinal area temperature. Infrared thermal imaging technology can provide a new method for ITP children's condition assessment and curative effect evaluation
〔Keywords〕 primary immune thrombocytopenia; children; infrared thermal imaging; non-uniformity; relative thermal calorific value data
原發免疫性血小板减少症(immune thrombocytopenia，ITP)是一种以血小板减少导致出血的自身免疫疾病[1]。流行病学资料表明，ITP在国外儿童年发病率为1.9～6.6/10万，国内儿童约为4～5/10万，其病因尚不明确，70%～80%的患儿可以痊愈，20%～30%的患儿逐渐演变成持续性、慢性ITP[2-3]。目前ITP发病机制尚不明确，其发病机制的研究主要涉及体液免疫异常、细胞免疫异常、血小板生成不足和破坏异常4个方面[4]。ITP的诊断目前仍属于排除性诊断，需要进行骨髓穿刺和各种血液学检查，其中骨髓穿刺为创伤性检查，因此患儿依从性差，且有严重出血倾向时也不宜行此项检查，而其他实验室检查也需抽取足够的血液标本。所以寻求一种为ITP儿童临床诊断与疗效观察提供更多信息，且无创、无辐射、灵敏、便捷、价廉的检查手段意义重大。, 百拇医药(王月 余惠平 高梦蕉 洪文学 宓保宏 张文征)
〔关键词〕 原发免疫性血小板减少症;儿童;红外热成像;非均一性;相对热态差值
〔中图分类号〕R259;R558+.2 〔文献标志码〕A 〔文章编号〕doi：10.3969/j.issn.1674-070X.2020.05.014
〔Abstract〕 Objective To observe the difference of infrared thermal imaging between children with primary immune thrombocytopenia (ITP) and healthy children by using infrared thermal imaging technology， so as to provide a new visual index for clinical diagnosis and treatment of ITP children and clinical efficacy evaluation. Methods The infrared charts of 22 ITP children (ITP group) and 11 healthy children (control group) were collected， and the non-uniformity of the trunk area and limb proximal area were statistically analyzed， and the relative thermal calorific value data (△t) of the differences between the trunk sanjiao area， palms area， face area and the trunk area were statistically analyzed. Results The non-uniformity of ITP group was significantly greater than that of the control group， and the difference was statistically significant (t=3.432， P<0.01). The △t of palms area in the ITP group was significantly larger than those of the control group， and the difference was statistically significant (t=3.438， P<0.01). The △t of spinal region in the ITP group was smaller than that in the control group， and the difference was statistically significant (t=-2.239， P<0.05). The △t of Sanjiao in the healthy group sequenced： upper jiao < middle jiao < lower jiao. And the ITP group sequenced： upper jiao > middle jiao > lower jiao. Conclusion Compared with healthy children， children with ITP have poor uniformity in trunk area and proximal limbs area， and have significant differences in palms area and spinal area temperature. Infrared thermal imaging technology can provide a new method for ITP children's condition assessment and curative effect evaluation
〔Keywords〕 primary immune thrombocytopenia; children; infrared thermal imaging; non-uniformity; relative thermal calorific value data
原發免疫性血小板减少症(immune thrombocytopenia，ITP)是一种以血小板减少导致出血的自身免疫疾病[1]。流行病学资料表明，ITP在国外儿童年发病率为1.9～6.6/10万，国内儿童约为4～5/10万，其病因尚不明确，70%～80%的患儿可以痊愈，20%～30%的患儿逐渐演变成持续性、慢性ITP[2-3]。目前ITP发病机制尚不明确，其发病机制的研究主要涉及体液免疫异常、细胞免疫异常、血小板生成不足和破坏异常4个方面[4]。ITP的诊断目前仍属于排除性诊断，需要进行骨髓穿刺和各种血液学检查，其中骨髓穿刺为创伤性检查，因此患儿依从性差，且有严重出血倾向时也不宜行此项检查，而其他实验室检查也需抽取足够的血液标本。所以寻求一种为ITP儿童临床诊断与疗效观察提供更多信息，且无创、无辐射、灵敏、便捷、价廉的检查手段意义重大。, 百拇医药(王月 余惠平 高梦蕉 洪文学 宓保宏 张文征)