摘要
目的:探讨血栓性血小板减少性紫癜(TTP)患者的临床特征及治疗反应,提高对TTP的诊断及治疗水平。方法:回顾性分析29例患者的临床表现、实验室检查结果、诊治及疗效。结果:29例TTP患者,平均年龄43岁,62%(18/29)为女性。8例(27.6%)临床出现典型五联征(发热、血小板减少、微血管病性溶血性贫血、神经系统症状和肾脏损害);23(79.3%)例TTP患者表现三联征(血小板减少、微血管病性溶血性贫血、神经系统症状)。所有的患者外周血涂片可见破碎红细胞,均值为8.9%(2%-20%)。本组病例以血浆置换(PE)和血浆输注(PI)治疗为主,18例患者予以PE治疗,中位置换次数为4.5次(1-10次),9例患者予以PI治疗,PE组和PI组有效率分别为72.2%和22.2%,差异有统计学意义(P=0.0369)。结论:TTP女性多见,"三联征"为其突出临床表现,血清乳酸脱氢酶及外周血破碎红细胞计数升高对诊断具有重要参考价值。PE疗效显著优于PI,为治疗TTP的首选方法。
Objective To investigate clinical features,out come and laboratory characteristics of thrombotic thrombocytopenic purpura （TTP） and improve diagnostic ability for physician in TTP management. Methods The clinical,laboratory data and treatment of 29 cases with TTP were reviewed retrospectively. Results sixty-two percent of the patients were females.The average age of the pa-tients was 43 years（range：12-66）.There were 8 patients（27.6%）with the triad of TTP,including hemolytic anemia,thrombocytopenia and neurologic abnormalities;23（79.3%）had the classical pental of TTP.The schistocytes of peripheral blood smears were present in 29 cases with a median of 8.9%.27 patients after diagnosis received either plasmaexchange（PE） or plasma infusion（PI）. The efficacy of PE had significantly better than that of PI（ cure rate：72.2%versus22.2%, P=0. 0369）. Conclusion TTP is common in female,the most prominent clinical abnormalities of TTP at presentation are the traid of hemolytic anemia,thrombocytopenia and neurologic abnormali-ties,and The increased serum lactate dehydrogenises and schistocytes counts are of great significance for diagnosis.Plasmapheresis is still the optimal treatment method for patients of TTP.
出处
《激光杂志》
CAS
CSCD
北大核心
2014年第3期73-75,共3页
Laser Journal
关键词
血栓性血小板减少性紫癜
临床特征
血浆置换
Thromboticthrombocytopenic purpura
Clinical features
Plasmapheresis（PE）
