表现为重度血小板减少的灾难性抗磷脂抗体综合征1例并文献复习

doi:10.3969/j.issn.1002-1949.2018.07.0018

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摘要目的探讨灾难性抗磷脂抗体综合征（CAPS）临床表现、诊断、鉴别诊断及治疗方法。方法对北京协和医院急诊科收治的1例以多脏器受累、重度血小板减少为主要表现的CAPS的临床资料进行分析。结果本例因反复血小板减少5年余，尿少、视力下降、头痛1月余入院。曾被外院诊断为血小板减少性紫癜，本次暴发性发作被外院诊断为急性肾功能衰竭和心功能衰竭。入院后经完善检查，患者抗心磷脂抗体＞120 U/mL，同时出现多脏器受累，排除其他疾病，考虑可疑CAPS。经抗凝、激素冲击、血浆置换后患者转危为安，随诊11个月仍存活。结论 CAPS临床罕见，误诊率及病死率极高，临床除多器官功能衰竭表现外，可能表现为反复血小板减少，应注意加以鉴别。

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	刘丹瑜
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	于学忠

关键词 ：灾难性抗磷脂抗体综合征（CAPS）, 血小板减少, 误诊漏诊, 血小板减少性紫癜

通讯作者: 于学忠(1958-)，男，博士，急诊科主任，主任医师，教授，博士生导师， E-mail: yxzpumch@126.com。

作者简介: 刘丹瑜（1991-），女，博士研究生，住院医师，E-mail:danyu_liu@foxmail.com。

引用本文:

刘丹瑜，刘业成，于学忠. 表现为重度血小板减少的灾难性抗磷脂抗体综合征1例并文献复习[J]. 中国急救医学, 2018, 38(7): 645-648.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.07.0018 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I7/645

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