57例免疫性血小板减少症临床分析

张小平; 吴要功; 杨迪; 赵苗苗; 陈文兰; 王雅丹; 胡豫

doi:10.13201/j.issn.1004-2806.2019.03.007

57例免疫性血小板减少症临床分析

- 华中科技大学同济医学院附属协和医院血液病学研究所(武汉, 430022)

详细信息

通讯作者: 胡豫,E-mail:dr_huyu@126.com

中图分类号: R558.2

收稿日期: 2018-07-01

Clinical analysis of 57 patients with immune thrombocytopenia

- Institute of Hematology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: HU Yu, E-mail: dr_huyu@126.com

Received Date: 01 July 2018

摘要

摘要: 目的:探讨免疫性血小板减少症(ITP)患者的临床特征。方法:回顾性分析57例ITP患者的临床资料,统计分析患者年龄、疾病分型及分期、出血评分、治疗方案[包括糖皮质激素、人免疫球蛋白(PH4)、重组人血小板生成素注射液等]、血小板输注数量、有效反应时间、完全反应(CR)时间、免疫学相关检查等在不同组别间的差异。结果:①不同年龄分组和不同性别分组间出血评分值、血小板输注数量、有效反应时间及CR时间差异均无统计学意义(均P>0.05);②重症ITP组(37例)的出血评分值、血小板输注数量、有效反应时间均明显高于非重症ITP组(20例)(均P<0.05),而2组CR时间差异无统计学意义(P=0.277);③原发性ITP组(24例)与继发性ITP组(33例)在年龄、出血评分、血小板输注数量、有效反应时间及CR时间方面差异均无统计学意义(均P>0.05);④单药治疗组(26例)和多药联合治疗组(31例)中重症ITP患者分别占38.5%(10/26)和87.1%(27/31),差异有统计学意义(P=0.000)。结论:糖皮质激素是原发性和继发性ITP患者的有效治疗方式;对于重症ITP患者,联合药物治疗可提高疗效。
- 免疫性血小板减少症 /
- 糖皮质激素 /
- 完全反应 /
- 出血评分
Abstract: Objective:To explore the clinical characteristics of patients with immune thrombocytopenia (ITP).Method:We retrospectively analyzed the clinical data of 57 patients with ITP and statistically analyzed the difference of patients' age,staging and classification of ITP,bleeding assessment,treatment methods [including glucocorticoid,human immunoglobulin (PH4),recombinant human thrombopoietin injection,etc.],number of platelet infusion,time to effective reaction,time to complete remission (CR) and results of immunological tests among different groups.Result:①There was no significant difference of values of bleeding assessment,number of platelet infusion,time to effective reaction and time to CR between subgroups divided by age and sex (all P>0.05);②Score of bleeding assessment,number of platelet infusion and time to effective reaction in severe ITP group (n=37) were significantly higher than those in non-severe ITP group (n=20) (all P<0.05),but there was no significant difference in time to CR between the two subgroups (P=0.277);③There was no significant difference in patients' age,score of bleeding assessment,number of platelet infusion,time to effective reaction and time to CR between primary ITP group (n=24) and secondary ITP group (n=33) (all P>0.05);④The proportion of severe ITP patients was 38.5% (10/26) in the single drug therapy group (n=26) and 87.1% (27/31) in the combination drug therapy group (n=31),respectively.There was significant difference (P=0.000).Conclusion:Glucocorticoid is an effective method for the treatment of both primary ITP patients and secondary ITP patients.And two or more drugs combination may improve the curative effects of patients with severe ITP.
- immune thrombocytopenia /
- glucocorticoid /
- complete remission /
- bleeding assessment

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参考文献(7)

[1]	[CM (72mm]王明镜,胡晓梅,邓中阳,等.免疫性血小板减少症的免疫机制研究进展[J].临床血液学杂志,2017,30(9):725-728.
[2]	Quach ME,Dragovich MA,Chen W,et al.Fc-independent immune thrombocytopenia via mechanomolecular signaling in platelets[J].Blood,2018,131:787-796.
[3]	McKenzie CG,Guo L,Freedman J,et al.Cellular immune dysfunction in immune thrombocytopenia (ITP)[J].Br J Haematol,2016,163:10-23.
[4]	Provan D,Stasi R,Newland AC,et al.International consensus report on the investigation and management of primary immune thrombocytopenia[J].Blood,2010,115:168-186.
[5]	张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:172-176.
[6]	Moulis G,Palmaro A,Montastruc JL,et al.Epidemiology of incident immune thrombocytopenia-a nationwide population-based study in France[J].Blood,2014,124:3308-3315.
[7]	Rodeghiero F,Michel M,Gernsheimer T,et al.Standardization of bleeding assessment in immune thrombocytopenia:report from the International Working Group[J].Blood,2013,121:2596-2606.