摘要
目的:探讨血栓性血小板减少性紫癜(TTP)患者的临床表现及治疗方法。方法:回顾性分析6例TTP患者的临床表现、治疗过程及转归。结果:6例患者均有不同程度的血小板减少、溶血现象、乳酸脱氢酶升高、间接胆红素升高,外周血可见破碎红细胞;其中有发热症状3例,合并神经系统症状4例,肾功能异常5例,系统性红斑狼疮继发1例。3例血管性血友病因子裂解酶(ADAMTS13)活性明显减低(均低于2.5%)。6例均接受血浆置换、糖皮质激素治疗,有效3例,部分有效2例,无效1例。结论:TTP的临床表现为微血管病性溶血性贫血、血小板减少、发热及肾脏损害等,诊断需靠临床资料综合分析。早期诊断、及早进行血浆置换有助于控制病情,降低病死率,改善患者预后。
Objective:In order to understand the treatment and outcome of six patients suffering from thrombotic thrombocytopenic purpura(TTP).Methods:The clinical features,laboratory characteristics,treatment and outcome of TTP patients were retrospectively analyzed and investigated.Results:The results showed that all 6 patients possessed varying degrees of platelet counts decreased,hemolytic anemia,lactic dehydrogenase increased,indirect bilirubin increased and peripheral blood red cells fragmentation.3 patients possessed fever symptoms,4 out of 6 patients complicated with nervous system symptoms,5 patients complicated with renal function abnormalities and 1 patients developed secondary systemic lupus erythematosus.Activity of ADAMTS 13 results revealed 3 patients were significantly decreased(less than 2.5%).All patients received treatment with plasma exchange and glucocorticoid,5 patients were in remission.Conclusion:TTP possess symptoms of microangiopathic hemolytic anemia,thrombocytopenia,fever andrenal function abnormalities.Comprehensive analysis of symptoms,early diagnosis and plasma exchange contrbute to control the disease,reduce the mortality and improve the prognosis of patients.
作者
杜小丽
王清
郭鹏翔
陈勇
DU Xiaoli;WANG Qing;GUO Pengxiang;CHEN Yong(Guizhou Provincial People′s Hospital,Guiyang 550002,China;The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China)
出处
《临床医药实践》
2020年第4期250-252,共3页
Proceeding of Clinical Medicine
