引用本文:许 敏,邓东红,杨 杰,程 鹏.血栓性血小板减少性紫癜18例临床分析[J].中国临床新医学,2013,6(5):425-428.
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血栓性血小板减少性紫癜18例临床分析
许 敏,邓东红,杨 杰,程 鹏
530021 南宁,广西医科大学第一附属医院血液内科
摘要:
[摘要] 目的 回顾性分析血栓性血小板减少性紫癜(TTP)患者的临床特点、实验室检查、治疗及预后,以提高对本病的诊断和治疗水平。方法 对18例TTP患者的临床表现、治疗及预后进行回顾性分析。结果 就诊表现为五联征或三联征患者为77.8%,所有患者在治疗过程中逐渐表现出五联征。接受血浆置换治疗12例,有效率为75.0%;未接受血浆置换治疗6例均死亡。结论 应提高TTP早期诊断水平,治疗上积极进行血浆置换,最大程度提高生存率。TTP诊断标准是否应放宽有待商榷。
关键词:  血栓性血小板减少性紫癜  临床特点  诊断依据  血浆置换
DOI:10.3969/j.issn.1674-3806.2013.05.08
分类号:R 55
基金项目:
Thrombotic thrombocytopenic purpura: clinical analysis of 18 cases
XU Min, DENG Dong-hong, YANG Jie, et al.
Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
Abstract:
[Abstract] Objective To investigate clinical features, outcome and laboratory characteristics of thrombotic thrombocytopenic purpura (TTP) and improve diagnostic ability for physicians in TTP management.Methods The clinical features, treatment and prognosis of 18 TTP patients were retrospectively analyzed.Results There were 77.8% patients with the triad of TTP, including hemolytic anemia, thrombocytopenia and neurologic abnormalities or had the classical pentad of TTP. All the patients showed the classical pentad of TTP in the process of treatment. Twelve patients accepted plasmapheresis, 75.0% of them achieved complete remission. Six patients without plasmapheresis all died.Conclusion In order to improve early diagnostic ability, to be active to use plasma exchange therapy and to maximize survival, whether the diagnostic criteria of TTP should be relaxed or not remains further discussion.
Key words:  Thrombotic thrombocytopenic purpura  Clinical features  Diagnostic basis  Plasmapheresis