摘要
目的:进一步提高对血栓性血小板减少性紫癜(TTP)诊疗的认识。方法:回顾性分析我院收治的7例非典型TTP患者的临床资料。结果:7例TTP患者初诊时均无典型五联征,但均具备血小板减少及微血管病性溶血二联征。诊断确立后予血浆置换联合糖皮质激素,6例有效。1例死亡。2例复发患者予利妥昔单抗治疗,均完全缓解。结论:TTP患者早期快速诊断、经确诊立即应用血浆置换对降低TTP患者的病死率至关重要,联合糖皮质激素及CD20单抗治疗可以进一步降低TTP患者的病死率及复发率。
Objective： To improve the understanding of the diagnosis and treatment of thrombotic thrombocytopenic purpura（ TTP）. Methods： Clinical data of 7 cases with atypical TTP were analyzed retrospectively. Results： None of the 7 cases showed typical five clinical manifestations at initial stage,but all have thrombocytopenia and microangiopathic hemolysis.All patients received a combination therapy of plasma exchange and steroids immediately once the diagnosis was made. 6 cases response to treatment,1 case died. Two relapsed patients treated with rituximab and achieved complete remission. Conclusion： Early detect and identify the disease,start treatment immediately with plasma exchange is crucial to reduce the mortality in patients with TTP. Combination with steroids and CD20 monoclonal antibody may further reduce the mortality and relapse rate.
出处
《内科急危重症杂志》
2015年第3期213-216,共4页
Journal of Critical Care In Internal Medicine
