血浆置换治疗血栓性血小板减少性紫癜及影响因素研究

Plasma exchange treatment of thrombotic thrombocytopenic purpura and its influential factors

目的探讨血浆置换(PE)治疗血栓性血小板减少性紫癜(TTP)临床疗效评价及影响因素的相关性研究。方法对12例TTP患者进行PE治疗,每例连续进行3次以上,每次置换60～80ml/kg,治疗期间同时运用免疫抑制剂。结果12例TTP患者中,2例死亡,1例转院,9例患者贫血纠正,出血症状好转,发热消退,血小板计数上升至正常水平,肾功能(肌肝、尿素氮)指标恢复正常,乳酸脱氢酶(LDH)下降至400U/L以下,6例痊愈出院,3例临床症状得到缓解和控制,有效率达75%。结论PE治疗对TTP患者疗效显著,禁忌输注血小板与冷沉淀。

Objective To study plasma exchange （PE） in the treatment of thrombotic thrombocytopenic purpura （TTP） , the clinical evaluation of the curative effect and the correlation of related factors. Methods 12 patients with TTP were treated with PE for more than three times. Replacement quantity was 60ml-80ml /Kg each time, simultaneously using immunosuppressive treatment. Results Of 12 patients with TTP, 2 cases died, 1 case was transferred, 9 cases had correction of anemia, improvement of bleeding symptoms, dissipation of fever, platelet count rose to normal levels, and renal function （creatinine, blood urea nitrogen） indexes returned to normal, lactate dehydrogenase LDH dropped to below 400, 6 cases were discharged, 3 cases had alleviation and control of clinical symptoms. The effective rate was 75%. Conclusion PE for the treatment of TTP has obvious effect. Platelet transfusion and cryoprecipitate are prohibited.