摘要
血栓性血小板减少性紫癜(Thrombotic thrombocytopenic purpura,TTP)典型临床表现包括发热,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五大主征。典型病理改变为微循环广泛透明血栓形成,引起相应供血的组织器官功能障碍。该病临床症状及体征变异度大,容易误诊或漏诊。近年来研究发现部分TTP患者存在血浆vWF裂解酶ADAMTS13活性缺陷,但仍无足够证据表明ADAMTS13活性测定能够帮助TTP治疗的临床抉择,可能还存在其他TTP发病机制有待进一步研究。
出处
《国际输血及血液学杂志》
CAS
2010年第2期122-125,共4页
International Journal of Blood Transfusion and Hematology
参考文献32
-
1Moschcowitz E.An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries.Arch Intern Med,1925,36 (1):89-93.
-
2Moake JL.Thrombotic microangiopathies.N Engl J Med,2002,347(8):589-600.
-
3Allford SL,Machin SJ.Current understanding of the patho physiology of thrombotic thrombocytopenic purpura.J Clin Pathol,2000,53(7):497-501.
-
4Schulman I,Pierce M,Lukens A,et al.Studies on thrombopoiesis,h a factor in normal human plasma required for platelet productions chronic thrombocytopenia due to its deficiency.Blood,1960,16:943-957.
-
5Upshaw JD Jr.Congenital deficiency of a factor in normal plasma that reverses microangiopathic hemolysis and thrombocytopenia.N Engl J Med,1978,298(24):1350-1352.
-
6Rarick MU,Espina B,Mocharnuk R,et al.Thrombotic thrombocytopenic purpura in patients with human immunodeficiency virus infection:a report of three cases and review of the literature.Am J Hematol,1992,40(2):103-109.
-
7Roy V,Rizvi MA,Vesely SK,et al.Thrombotic thrombocytopenic purpura-like syndromes following bone marrow transplantation:an analysis of associated conditions and clinical outcomes.Bone Marrow Transplant,2001,27 (6):641-646.
-
8George JN.The association of pregnancy with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.Curr Opin Hematol,2003,10(5):339-344.
-
9Tsai H-M,Rice L,Sarode R,et al.Antibody inhibitors to yon Willebrand factor metalloproteinase and increased binding of yon Willebrand factor to platelets in ticlopidine-associated thrombotic thrombocytopenic purpura.Ann Intern Med,2000,132 (10):794-799.
-
10Bennett CL,Connors JM,Carwile JM,et al.Thrombotic thrombocytopenic purpura associated with clopidogrel.N Engt J Med,2000,342(24):1773-1777.
同被引文献26
-
1谢飞,王鸿利,王学锋,丁秋兰,方怡,戴菁,蔡晓虹,王振义.血管性血友病诊断与分型方法的建立和临床应用[J].中华检验医学杂志,2006,29(9):804-806. 被引量:3
-
2Moschcowitz E.Hyaline thrombosis of the terminal arterioles and capillaries:a hitherto undescribed disease.1925.Mt Sinai J Med,2003,70(5):352.
-
3Tsai HM.Physiologic cleavage of Von Willebrand factor by a plasma protease is dependent on its conformation and requires calcium ion.Blood,1996,87(10):4235.
-
4Veyradier A,Obert B,Houllier A,et al.Specific yon Willebrand factor-cleaving protease in thrombotic microangiopathies;a study of 111 cases.Blood,2001,98(6):1765.
-
5George JN.The association of pregnancy with thrombotic thromboeytopenic purpura-hemolytic uremic syndrome.Curr Opin Hematol,2003,10(5):339.
-
6Tsai HM,Rice I,Sarode R,et a1.Antibody inhibitors to yon Willebrand factor metalloproteinase and increased binding of von Willebrand factor to platelets in ticlopidine-associated thrombotic thrombocytopenie purpura.Ann Intern Med,2000,l32(10):794.
-
7金惠铭;王建枝.病理生理学[M]{H}北京:人民卫生出版社,200883-95.
-
8Matsumoto M. Diagnosis and management of thrombotic microangiopathies[J]. Rinsho Ketsueki, 2015, 56 (10): 2092- 2099. DOI: 10.11406/rinketsu. 56.2086.
-
9Connell NT, Cheves T, Sweeney JD. Effect of ADAMTS13 activity turnaround time on plasma utilization for suspected thrombotic thrombocytopenie purpura[J]. Transfusion, 2016,56 (2) :354-359. DOI: 10.1111/trf. 13359.
-
10Mariotte E, Veyradier A. Thrombotic thrombocytopenic purpura: from diagnosis to therapy[J]. Curr Opin Crit Care, 2015,21(6) :593-601. DOI: 10. 1097/MCC. 0000000000000255.
引证文献4
-
1罗曼.以神经系统症状为首发的血栓性血小板减少性紫癜1例诊治体会[J].岭南急诊医学杂志,2011,16(2):160-160. 被引量:1
-
2朱伟.“平衡”理念在病理生理学教学中的应用[J].内蒙古中医药,2013,32(34):113-113.
-
3鲁旭娟,李笑峰,陈满强,谢晓园.影响获得性血栓性血小板减少性紫癜首次缓解期内复发的相关指标研究[J].国际输血及血液学杂志,2016,39(5):374-379. 被引量:1
-
4卢聪,江慧雯,魏求哲,胡俊斌,吴耀辉.血栓性血小板减少性紫癜的临床特点和预后因素分析[J].临床血液学杂志,2025,38(1):9-13. 被引量:4
二级引证文献6
-
1姜文娟,李晓曦,刘文静,何志义.以神经系统症状为首发表现的血栓性血小板减少性紫癜1例报告并文献复习62例临床分析[J].中风与神经疾病杂志,2018,35(1):35-39. 被引量:4
-
2郑璐,刘永华,江锦红,方炳木.复发TTP治疗后再发Evans综合征1例[J].温州医科大学学报,2021,51(7):591-592.
-
3向国强,宋正芳,向航,吴耀辉,胡俊斌,卢聪.多学科联合诊疗1例血栓性血小板减少性紫癜[J].临床血液学杂志,2025,38(7):529-532.
-
4范圣瑾,李海涛,张曦.推进血液重症监护病房建设,提高血液专科重症救治能力[J].中华血液学杂志,2025,46(11):985-990.
-
5张营,彭银霜,相代荣,邹鹏飞,苏俊威.艾滋病并发血栓性血小板减少性紫癜1例[J].中华临床感染病杂志(中英文),2025,18(5):386-389.
-
6黄洁,刘琴,唐新玉,林静,廖桂萍,陈要朋.血浆置换联合激素与小剂量利妥昔单抗对血栓性血小板减少性紫癜的治疗效果:一项回顾性研究[J].血栓与止血学,2025,31(6):247-253.
-
1刘仁同,付蓉.血栓性血小板减少性紫癜4例并文献复习[J].中国老年学杂志,2012,32(9):1956-1958. 被引量:1
-
2朱庆云,陈佩玲,魏霞,谢伦芳.系统性红斑狼疮合并血栓性血小板减少性紫癜患者的护理[J].护士进修杂志,2016,31(8):730-733. 被引量:16
-
3钟雯婷,李海亮.1例继发性血栓性血小板减少性紫癜病例分析及文献复习[J].赣南医学院学报,2014,34(1):93-94. 被引量:2
-
4习杰英,张梅,贺鹏程,王梦昌,刘心,陈丽梅,吴迪,朱华超.血栓性血小板减少性紫癜诊断与误诊分析[J].临床荟萃,2012,27(16):1446-1448.
-
5高维强,王兆钺,白霞,阮长耿.汉族正常人群与血栓性疾病患者vWF裂解酶C1423T基因多态性调查[J].中华血液学杂志,2004,25(3):136-138. 被引量:2
-
6张琨琨,李忠俊.血浆置换治疗血栓性血小板减少性紫癜1例[J].重庆医学,2006,35(11):986-986. 被引量:1
-
7孙川,张英辉,卓曼云,孟杰.血栓性血小板减少性紫癜患者的临床治疗[J].华南国防医学杂志,2014,28(9):917-919. 被引量:1
-
8任丽,张楠,周广喜.以神经系统症状首发的血栓性血小板减少性紫癜一例报道并文献复习[J].中华神经医学杂志,2010,9(10):1067-1068. 被引量:2
-
9闫兴双,冯术青,李晓宇,朱梦波,杜小梅,崔晓聪,高峰.血栓性血小板减少性紫癜二例[J].中国综合临床,2011,27(5):552-554. 被引量:2
-
10曾清华,饶慧,黄安兰.以血栓性血小板减少性紫癜为首发表现的系统性红斑狼疮一例并文献复习[J].现代医学,2013,41(1):51-52. 被引量:2