9例血栓性血小板减少性紫癜的临床分析

The Clinic Analysis of 9 Patients of Thrombotic Thrombocytopenic Purpura

目的分析血栓性血小板减少性紫癜(TTP)的临床特征和治疗方法选择的价值。方法对9例TTP患者的临床资料进行分析。结果9例患者6例为女性,男∶女=1∶3;其中系统性的红斑狼疮5例,严重感染、败血症3例,尿毒症1例。临床表现以血小板减少性出血、微血管病性溶血性贫血和神经系统症状的"三联症"起病的5例;三联症伴发热和肾脏病变"五联症"起病的2例;三联症伴发热起病2例。4例及时进行血浆置换为主治疗后均有效;其余5例未给予血浆置换的3例死亡。结论TTP多见于年轻女性,病因以系统性红斑狼疮最多见,感染次之。临床表现以三联征表现最多,以后多表现为四联征或五联征。及时给予血浆置换为主的治疗抢救成功率较高。

Objecttive To analyze the value of clinical feature and selective of therapy method in patients with thrombotic thrombocytopenic purpura. Methods The clinical data of 9 patients with thrombotic thrombocytopenic purpura was analyzed. Results There were 6 female in 9 patients thrombotic thrombocyto- penic purpura, and man/women was 1：3. The 5 patients were caused by SLE, and 3 were caused by serious infection, and 1 was caused by uremia. The 5 patients onsted with trilogy of plate-reduction hemorrhage. Microangiopathies hemolytic anemia and nervous system symptom, another 2 patients onsted with pentalogy of trilogy and fever, renal lesions. The 4 patients treated with plasmapheresis in time had good effect, but 3 patients were died of other 5 patients without treated with plasmapheresis. Conclusion There are more female patients in patients with thrombotic thrombocytopenic purpura. The main etiological factor is SLE, and the next in order is infection. The initial clinical manifestation is trilogy, afterward is tetrad or pentalogy. The rescue achievement ratio is higher when treated by plasmapheresis in time.