山莨菪碱联合血浆置换治疗血栓性血小板减少性紫癜中血小板变化的意义

Significance of platelet changes in thrombotic thrombocytopenic purpura patients by treatment of anisodamine combined with plasma exchange

目的探讨血小板变化在山莨菪碱联合血浆置换治疗血栓性血小板减少性紫癜(TTP)中的临床意义。方法将本院收治的78例TTP患者随机分为2组,每组39例。研究组给予山莨菪碱联合血浆置换治疗,对照组仅给予血浆置换治疗,疗程均为21 d。观察2组治疗前及治疗后第2、5、12、21天血小板计数的变化及不良反应发生情况,并比较临床疗效。结果研究组治愈率显著高于对照组,且总有效率有高于对照组的趋势。治疗后第2、5、12、21天,2组血小板计数均较治疗前明显增多;治疗后第2、5、12天,研究组血小板计数显著多于对照组,差异有统计学意义。治疗期间,2组均未见严重不良反应。结论血浆置换联合山莨菪碱能有效加速TTP患者血小板的恢复,减少血小板消耗及微血栓形成,疗效显著,且安全性较好。

Objective To explore the clinical significance of platelet changes in thrombotic thrombocytopenic purpura （TTP）patients by treatment of anisodamine combined with plasma ex-change.Methods 78 patients with TTP were randomly divided into two groups,39 cases in each group.The research group was treated with anisodamine combined with plasma exchange,while the control group was treated only with plasma exchange.Changes of platelet counts before treatment and on days 2,5,12 and 21 after treatment as well as incidence of adverse reactions were observed in two groups.Clinical efficacy was compared.Results In the research group,healing rate was significantly higher and overall response rate was slightly higher than control group.On days 2,5, 12 and 21 after treatment,the platelet counts in both groups increased obviously.On days 2,5 and after treatment,the platelet count in research group was significantly greater than in control group. During treatment,no severe adverse reactions were observed in both groups.Conclusion Aniso-damine combined with plasma exchange can effectively accelerate the recovery of platelets in patients with TTP,reduce platelet consumption and microthrombosis and shows a significant efficacy and better safety.