关键词: 免疫性血小板减少症, 临床表现, 治疗, 不良反应

Abstract:

Objective To analyze the clinical manifestations and treatment effects of 193 adult patients with immune thrombocytopenic purpura(ITP). Methods Clinical features of 193 cases who suffered from ITP were retrospectively studied. Results Adult ITP patients were mostly(79.3%)in chronic course. Some of them had a history of infection(22.8%); 86.5% patients had a manifestation of hemorrhage. Petechiae and ecchymosis were the most common clinical symptoms in ITP patients(77.7%), 5 patients(2.6%)died of cerebral hemorrhage. The platelet count was lower in hemorrhage patients(P=0.000)0.86% patients received glucocorticosteroid or glucocorticosteroid based combination regimen, 69.3% patients achieved a response. Platelet count less than 20×10⁹/L, female, younger patients(15~40 years old)and the patients who had a manifestation of hemorrhage had a better response to the treatment (P=0.011, 0.029, 0.000 and 0.004, respectively). Bone marrow megakaryocytes and serum ANA had no correlation with therapeutic effect (P=0.054 and 0.179, respectively). 23.8% patients developed side effects related to treatment, 6.2% had liver toxicity, and 6.1% patients had an elevated blood glucose and 1 patient(0.52%)died from severe lung infection. Conclusion Most of adult ITP patients were in chronic course. Glucocorticosteroid is still the first line treatment in ITP patients. Sex, age and platelet count may predict the treatment effects. The disease in ANA positive patients may become autoimmune disease as seen during a long period follow up.

Key words: immune thrombocytopenic purpura, manifestation, therapy, side effects