血栓性血小板减少性紫癜患者的临床分析

doi:10.3969/j.issn.1002-1949.2019.07.012

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摘要目的探讨血栓性血小板减少性紫癜（TTP）的临床特征、诊断、治疗及转归。方法回顾性分析北京大学人民医院2004年1月至2018年10月收治的59例TTP患者的临床资料。结果 59例TTP患者中，男性21例，女性38例，平均年龄（46.8±16.2）岁，55例表现为三联征，46例表现为五联征。血小板（13.2±12.0）×109/L,血红蛋白（66.8±20.7）g/L，外周血破碎红细胞（4.6±4.1）%，游离血红蛋白（426.2±298.2）mg/L，血管性血友病因子裂解酶（ADAMTS13）值或活性明显降低。59例患者均使用糖皮质激素，41例行血浆置换者，28例存活；18例未行血浆置换者，6例存活，二者差异有统计学意义（P＜0.05）。6例用利妥昔单抗治疗者，4例存活。结论及早治疗，使用血浆置换能明显提高TTP患者存活率，对于难治性TTP患者，建议尽早使用利妥昔单抗。

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	石茂静
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关键词 ：血栓性血小板减少性紫癜（TTP）, 血管性血友病因子裂解酶（ADAMTS13）, 血浆置换, 利妥昔单抗

通讯作者: 高伟波(1976-)，男，硕士，副主任医师，E-mail：13699185078@163.com。

作者简介: 石茂静(1986-)，女，硕士，主治医师，E-mail：shimaojing@126.com。

引用本文:

石茂静，黄文凤，高伟波，朱继红. 血栓性血小板减少性紫癜患者的临床分析[J]. 中国急救医学, 2019, 39(7): 667-671.
Shi Mao-jing, Huang Wen-feng, Gao Wei-bo, Zhu Ji-hong. Clinical analysis of patients with thrombotic thrombocytopenic purpura. Chinese Journal of Critical Care Medicine, 2019, 39(7): 667-671.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.07.012 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I7/667

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