系统性红斑狼疮相关血小板减少治疗现状

Current Status of Treatment of Thrombocytopenia Related to Systemic Lupus Erythematosus

系统性红斑狼疮患者血小板减少为轻到中度,不需要特别处理;但当出现出血、大血肿或血小板计数<30×109L时,则需要进行治疗。已有报道系统性红斑狼疮相关血小板计数减少的治疗药物和方法包括糖皮质激素、免疫抑制剂、静脉注射免疫球蛋白、羟氯喹、血浆置换、达那唑和脾脏切除,也包括一些新药(利妥昔单抗、促血小板生成素)和其他方法(应用氨苯砜、自体造血干细胞移植)。

Thrombocytopenia is a common manifestation of systemic lupus erythematosus.For those patients with mild to moderate thrombocytopenia, no specific treatment is needed. However, when they developed severe thrombocytopenia,ie,platelet level less than 30 ×10^9 /L,and complicated with hemorrhage,treatments must be initiated.The drugs and measures for thrombocytopenia related to systemic lupus erythematosus included glucocorticoid,immunosuppressive agents,intravenous immunoglobulins,hydroxychloroquine,plasma exchange, danazol,and splenectomy.Some new medicines （rituximab and thrombopoietin）and other methods （dapsone and autologous hematopoietic stem cell transplantation）were tried in the treatments for this situation.In this review, we summarized the current status of the treatments and challenges of severe thrombocytopenia in an evidence-based approach.