14例血栓性血小板减少性紫癜临床研究

Clinical study on thrombotic thrombocytopenic purpura in 14 cases

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方案，进而提高临床TTP 患者的诊疗水平。方法对14 例TTP 患者的一般情况、临床特征、实验室检查、治疗方案、疗效及预后进行回顾性研究。结果神经精神症状有13 例，五联症表现4 例，三联症表现9 例，复发2 例，死亡6 例。血浆置换（PE）前后血小板（PLT）、血红蛋白（Hb）及乳酸脱氢酶（LDH）监测值有不同，差异有统计学意义（P <0.05）。2 例患者联合利妥昔单抗治疗，缓解率为100%（2/2）。结论TTP患者多以三联症起病，常伴随精神神经症状，血浆置换是其首选治疗方案。对复发TTP 患者，利妥昔单抗可以提高缓解率。

Abstract:

Objective To investigate the clinical features and treatment of patients with thrombotic thrombocytopenic purpura (TTP) to improve the diagnosis and treatment level. Methods Retrospective study of 14 cases with TTP was conducted in general conditions clinical features, laboratory tests, treatment protocols,therapeutic effect and prognosis. Results Of the 14 patients, 13 had neurological symptoms, 4 had quinary syndrome, 9 had triad syndrome, 2 were recurrent and 6 were dead. The levels of platelet (PLT), hemoglobin (Hb) and lactate dehydrogenase (LDH) were significantly different between before and after plasma exchange (PE) (P < 0.05). Two patients were treated with Rituximab and its remission rate was 100% (2/2). Conclusions Most of patients with TTP often have triad syndrome onset and accompany by neurological symptoms, and plasma exchange is the most effective treatment. For recurrent ones, Rituximab can improve the remission rate.