摘要
目的探讨影响成人原发免疫性血小板减少症（ITP）疗效及预后的相关危险因素。方法回顾性分析2013年6月至2017年3月山西医科大学第二医院收治的成人ITP患者的临床及实验室检查结果等指标，总结其临床特点，并分析影响患者疗效及预后的相关危险因素。结果161例ITP患者的发病年龄18-84岁，中位发病年龄为45岁。男性60例，女性101例，男：女为0．59：1。新诊断ITP109例，持续性ITP14例，慢性ITP38例。79例患者接受丙种球蛋白治疗，82例接受大剂量地塞米松治疗，治疗有效患者共144例（89．44％），2种方案患者治疗有效率[91．13％（72／79）比87．80％（72／82），χ2=0．181，P=0．914]及复发率[36．11％（26／72）比30．55％（22／72），χ2=0．189，P=0．910]比较差异无统计学意义；多因素分析显示出血评分／〉2分为影响疗效的独立危险因素（RR=I．415，95％CI：1．008-1．986，P〈0．05）。中位随访时间9．0个月（0．5-55．0个月），复发48例（33．33％），中位复发时间为1．8个月（0．5-24．0个月），结论大剂量地塞米松与丙种球蛋白对ITP患者的疗效及复发风险接近；出血评分≥2分的患者出血风险高，治疗效果较差，应予以重视。
Objective To examine the influencing factors related to clinical efficacy and outcomes of adult primary immune thromboeytopenia （ITP）.Methods The clinical data of 161 cases of ITP admitted in the Second Hospital of Shanxi Medical University from June 2013 to March 2017 were collected. The influencing factors related to clinical efficacy and prognosis of adult ITP patients were analyzed. Results There were 60 males and 101 females with a M/F ratio of 0.59：1 and a median age of 45 years （18-84 years）. There were 109 newly diagnosed ITP cases, 14 persistent ITP cases and 38 chronic ITP cases in this series. Seventy nine patients received intravenous immunoglobulin g （IVIg） treatment and 82 patients received high dose-dexamethasone treatment.There were no significant differences in clinical efficacy [91.13%（72/79） vs. 87.80%（72/82）, χ2=0.181, P=0.914] and relapse rate [36.11%（26/72） vs. 30.55%（22/72）, χ2=0.189, P= 0.910] between IVIg and high dose-dexamethosone groups. Multivariate regression analysis showed that bleeding score ≥2 was the independent risk factor for the lower clinical efficacy （RR=l.415, 95%CI： 1.008- 1.986, P〈0.05）. Patients were followed up for a median of 9.0 months （0.5-55.0 months）, 48 patients relapsed with a relapse rate of 33.33% and a median relapse time of 1.8 months （0.5-24.0 months）. Conclusions IVIg and high dose-dexamethasone have the similar clinical efficacy and relapse rate for treatment of adult ITP. The patients with the bleeding score≥2 are more likely to get lower remission rate.
作者
陈屿
王梅芳
陈剑芳
张耀方
王刚
安泽峰
常姝婷
杨林花
Chen Yu;Wang Meifang(Chen Jianfang,Zhang Yaofang,Wang Gang,An Zefeng,Chang Shuting,Yang Linhua Department of Hematology,the Second Hospital Affiliated to Shanxi Medical University,Taiyuan 030001,China)
出处
《中华全科医师杂志》
2018年第10期794-797,共4页
Chinese Journal of General Practitioners
基金
山西省科技创新团队（201605D131044-05）
山西医科大学大学生创新创业校级项目（20160256）
山西省应用基础研究项目（201601D202094）
关键词
血小板减少
治疗结果
预后
Thrombocytopenia
Treatment outcome
Prognosis
