血浆置换联合激素、免疫抑制剂对血栓性血小板减少性紫癜患者的临床疗效分析

The clinical effects of plasma exchange combined with hormone and immunosuppressor in patients with thrombotic thrombocytopenic purpura

目的分析血浆置换(PE)联合激素、免疫抑制剂对血栓性血小板减少性紫癜(TTP)患者血常规和生化指标的影响。方法选择2012年1月至2017年1月枣庄市中心血站接诊的18例TTP患者进行研究,分为观察组和对照组,每组9例。对照组给予PE治疗,观察组在PE治疗基础上联合激素、免疫抑制剂治疗,比较两组患者治疗前后的临床疗效。结果观察组和对照组临床疗效总有效率分别为100.00%、88.88%,两组比较差异无统计学意义(P>0.05)。治疗后两组血红蛋白(Hb)和血小板(PLT)水平较治疗前均升高,组内治疗前后Hb和PLT水平比较,差异有统计学意义(P<0.05);且观察组Hb和PLT水平均高于对照组(P<0.05)。治疗后两组乳酸脱氢酶(LDH)、总胆红素(TBIL)、尿素氮(BUN)、血肌酐(Scr)和直接胆红素(dBIL)水平较治疗前均下降,差异有统计学意义(P<0.05);且观察组各生化指标水平均低于对照组(P<0.05)。结论 PE联合激素、免疫抑制剂治疗可显著提高TTP患者的临床疗效。

Objective To analyze the effects of plasma exchange(PE)combined with hormones and immunosuppressive agents on blood routine and biochemical indexes in patients with thrombotic thrombocytopenic purpura(TTP).Methods From January 2012 to January 2017,18 patients with TTP in our hospital were selected and divided into observation group and control group with 9 cases in each group.Patients in the control group were treated with PE,while patients in the observation group were treated with PE combined with hormones and immunosuppressive agents.The clinical effects before and after treatment were compared and analyzed.Results The total effective rate of the observation group and the control group was 100.00% and88.88%,respectively.There was no significant difference between the two groups(P>0.05).After treatment,the levels of Hb and PT in both groups were increased,and there was a significant difference before and after treatment(P<0.05),and the levels of Hb and PT in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of LDH,TBIL,BUN,Scr and dBIL biochemical indicators in the two groups decreased,and the levels of biochemical indicators in the observation group were lower than those in the control group(P<0.05).Conclusion PE combined with hormone and immunosuppressor can significantly improve the clinical effects of TTP patients.