顽固性ITP的原因与治疗

Causes of refractory immune thrombocytopenia and its management

免疫性血小板减少症（ITP）是一种较常见的免疫性疾病,主要发病机制是由于抗血小板自身抗体引起的血小板破坏并有血小板生成受限。ITP可发生于任何年龄,在儿童多数呈急性经过,自发缓解率高;而90%成人患者为慢性,其中15%对各种治疗不敏感。1 ITP治疗现状ITP患者在血小板计数明显降低特别是有出血倾向时都需要治疗,临床上一般分为一线治疗与二线治疗。

Refractory immune thrombocytopenia（ITP）is defined by the patients who meet the criteria for severe ITP and have failed to splenectomy.Refractory ITP may be related to many different conditions such as accessory spleen,other causes of non-ITP thrombocytopinea and misdiagnosis.The options for the management of these patients are limited.Removing accessory spleen as well as thrombopoietin-receptor agonists and rituximab could represent reasonable salvage treatment,and they should be treated individually.