部分羟乙基淀粉代血浆置换治疗血栓性血小板减少性紫癜11例临床研究

Clinical study on 11 cases of part hydroxyethyl starch on behalf of plasmapheresis treatment of thrombotic thrombocytopenic purpura

目的:对部分羟乙基淀粉代血浆置换技术应用于血栓性血小板减少性紫癜(TTP)进行治疗性研究。方法:进行血浆置换治疗的血栓性血小板减少性紫癜患者共11例,监测治疗前后生化指标的变化情况及转归情况。结果:治疗前后患者的临床症状及生化检查均有不同程度的改善,治疗后患者网织红细胞(Ret)、乳酸脱氢酶(LDH)、血肌酐(Cr)和尿素氮(BUN)与治疗前相比均明显下降(P<0.05),Hb、PLT较治疗前明显上升(P<0.05)。11例患者作血浆置换治疗59次,有效出院者8例,无效出院者1例,死亡1例,经济原因放弃1例,治疗次数2～4次者有效达87.5%。结论:应用部分羟乙基淀粉代血浆加新鲜血浆作为置换液进行血浆置换是治疗TTP患者的有效措施之一,对血浆置换的方法和方式进行研究,有利于减少血浆的使用量、减轻患者的经济负担。

Objective：To do therapeutic research on the part hydroxyethyl starch on behalf of the plasmapheresis used in thrombotic thrombocytopenic purpura（TTP）.Method：A total of 11TTP patients received plasma exchange treatment,and biochemical changes before and after treatment,as well as outcome of all patients were monitored.Result：Clinical symptoms and biochemical tests in patients before and after treatment had varying degrees improvement.Compared with before treatment,,reticulocyte（Ret）,lactate dehydrogenase（LDH）,creatinine（Cr）and urea nitrogen（BUN）decreased significantly after treatment（P〈0.05）,and Hb,PLT significantly increased（P〈0.05）.There were 59plasmapheresis for these 11patients,effective and discharge in 8cases,ineffective and discharge in one case,one patient died,and one gave up for economic reasons.The effective rate of patient received 2-4times plasmapheresis treatment was up to 87.5%.Conclusion：Taking part hydroxyethyl starch plasma of fresh plasma as replacement fluid for plasma exchange could be an effective measure for TTP treatment,and studies on ways and means of plasma exchange could help to reduce the use of plasma and reduce the patient＇s economic burden.