山莨菪碱联合血浆置换治疗血栓性血小板减少性紫癜患者血浆D-二聚体变化的意义

To analyze the variation of plasma D-dimer in the process of anisodamine combined with plasma exchange treatment of thrombotic thrombocytopenic purpura

目的探讨山莨菪碱(Ani)联合血浆置换(PE)治疗血栓性血小板减少性紫癜(TTP)患者血浆D-二聚体(D-D)的变化,从而了解Ani在TTP的治疗中纤溶亢进改善情况。方法选择68例TTP病人随机分成两组,每组34例。联合干预组给予Ani联合TPE治疗,而对照组只给予以PE治疗,疗程均21d。检测治疗前和治疗后2,5,10,16,21d两组血浆D-D数值变化。结果 2组治疗的第2d,差异无显著性(P>0.05),但联合干预组在治疗的第5,10,16,21d与对照组相比有显著性差异(P<0.05)。两组疗效的观察,联合干预组有效率为97.1%,对照组有效率为79.4%,2组的总疗效有显著性差异(P<0.05)。结论 Ani联合TPE能加快TTP患者血浆D-D数值的下降,有利于患者的预后恢复。

Objective To observe the variation of plasma D-dimer（D- D） and investigate the improvement of the hyperfibrinolysis and the clinic efficacy of plasma exchange （PE） combined with anisodamine（Ani） in the treatment of thrombotic thrombocytopenic purpura （TTP）. Methods 68 patients were randomized into two groups,each group contained 34 patients. The treatment group was given Ani injection combined with PE,the controlled group was just given PE, with a same course of 21 days duration. Observe the efficacy of the two groups, and the variation of plasma D-D was observed in the period of 2,5,10,16,21 days after the treatment. Results There was no difference between the two groups in 2 days＇ therapy （P〉0.05）. However there were significant differences （P〈0.05） in 2,5,10,16,21 days. The efficacy of the treatment group after 21 days is 97. 1%, the controlled group is 79. 4%, there were significant differences between the two groups （P〈0.05）. Conclusion Ani combined with PE shows better clinic effect and the D- D descends faster than PE alone in therapy of TTP.