摘要
目的探讨真性红细胞增多症(polycythemia vera,PV)的临床特点,减少误诊,提高诊治水平。方法分析研究诊治的30例PV的临床资料、实验室检查资料、治疗效果和随访转归。结果此病多发于中老年,平均年龄62岁;有症状者73.3%,无症状者26.7%;早期多为心脑缺氧症状,无特异性,容易误诊为心脑血管疾病;而皮肤黏膜紫红(100%)、脾大(70%)等体征有更大的诊断提示作用;JAK2V617F基因突变阳性率90%,有较好诊断价值;在JAK抑制剂普及应用之前,静脉放血结合羟基脲、干扰素的传统治疗方法,仍然值得推荐,有效率达86.7%,治疗无效者血栓发生率较高(3/4)。结论中老年人就诊需注意到不同寻常的皮肤黏膜紫红、难以解释的脾大和红细胞增多,以减少误诊。推广骨髓活检、JAK2V617F突变等指标,有利于提高诊断水平。传统治疗手段,缓解症状,防止血栓,仍然行之有效。
Objective Through the clinical analysis of 30 cases of polycythemia vera, we explore basic clinical characteristics of this disease, and reduce the misdiagnosis of polycythemia vera, so as to improve the treatment effeet. Methods This study analyzed clinical data of polycythemia vera in September 2008 to October 2013. Results In the 30 cases of patients with polycythemia vera,misdiagnosis were 10 cases, accounting for 33.3%; in the patients with good treatment, 8 cases of remission, 18 patients improved significantly, effective treatment accounted for 86.7%. Conclusion The early symptoms of polycythemia vera were not obvious. The misdiagnosis rate was high; in order to reduce the misdiagnosis, the therapeutic effect must be improved.
出处
《中国处方药》
2014年第1期35-36,共2页
Journal of China Prescription Drug
