血浆置换治疗血栓性血小板减少性紫癜的疗效观察

Curative effect of plasma exchange treatment on thrombotic thrombocytopenic purpura

目的：了解血浆置换治疗血栓性血小板减少性紫癜（TTP）的临床效果。方法：2011-2013年间确诊为TTP的10例患者进行血浆置换,每日1次,用新鲜冰冻血浆为置换液,每次2 000~3 000ml,治疗2~5次,记录治疗前后血液检验相关指标和临床症状改善情况。结果：10例患者中2例死亡,8例存活。存活患者在经过3~5次血浆置换后,血小板、血红蛋白逐渐上升,尿素氮、间接胆红素、乳酸脱氢酶逐渐降低,治疗前后血液检验指标差异有统计学意义。结论：血浆置换是TTP的首选疗法,对TTP患者尽早的进行血浆置换可明显降低病死率,提高治疗效果。

Objective：To learn the efficacy of plasma exchange in treating thrombotic thrombocytopenic purpura（TTP）.Method：Treating ten patients which were diagnosed as TTP in our hospital between 2011 and 2013with plasma exchange,using fresh frozen plasma as replacement fluid,each time 2000~3000ml,1time daily,for 2to5 days.Recording related indicators of blood test and the improvement of clinical symptoms before and after treatment.Result：In these 10 patients,2patients died and eight patients survived.After plasma exchange 3to 5times,survivors＇ broken RBC in peripheral blood disappeared,platelet（PLT）and hemoglobin（Hb）increased gradually,and blood urea nitrogen（BUN）,indirect bilirubin（IBIL）and lactate dehydrogenase（LDH）decreased gradually.The differences of blood test indicators before and after treatment were statistically significant.Conclusion：Plasma exchange would be the preferred treatment for TTP.Treating TTP patients with plasma exchange as soon as possible could reduce mortality significantly and improve the therapeutic effect.