Grading of hemorrhage in children with idiopathic thrombocytopenic purpura
Grading of hemorrhage in children with idiopathic thrombocytopenic purpura
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DOI：
10.1067/mpd.2002.128547
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发表时间：
2002-11-01
影响因子：
5.1
通讯作者：
Adix, L
中科院分区：
文献类型：
--
作者：
Buchanan, GR;Adix, L
目的：研制一种能够半定量评估儿童特发性血小板减少性紫癜(ITP)出血的工具。研究设计：根据过去24小时的病史和体格检查，对4个不同部位(全身、口腔、鼻出血和皮肤)的出血严重程度进行0到4的评分。结果：多个观察者对54例ITP患儿进行了109次不同场合的评估，其中一位作者测量了81次。出血程度与血小板计数呈负相关。除皮肤受累外，3级或4级出血少见，评估困难。7例出现4级粘膜或内出血，无一例发生危及生命或致命性出血。结论：我们得出结论：在ITP的儿童中，出血的分级是可能的，并且出血的分级可能在未来的研究中代表一个有临床意义的终点。
Objective: To develop an instrument to allow semiquantitative assessment of hemorrhage in children with idiopathic thrombocytopenic purpura (ITP).Study design: Bleeding severity was graded on a scale of 0 to 4 in 4 different sites (overall, oral, epistaxis, and skin) on the basis of history during the previous 24 hours and physical examination.Results: Children with ITP (n = 54) were assessed on 109 different occasions by multiple observers, including 81 measurements by one of the authors. Grade of bleeding correlated inversely with platelet count. Grade 3 or 4 hemorrhage was infrequently encountered except involving the skin, where assessment,,cas difficult. Grade 4 mucosal or internal hemorrhage was noted in 7 patients; none had life-threatening or fatal bleeding. Interrater agreement in grading of overall and mouth bleeding and epistaxis was acceptable.Conclusions: We conclude that scoring of hemorrhage is possible in children,with ITP and that the grade of hemorrhage may represent a clinically meaningful end point in future studies.