成人原发免疫性血小板减少症慢性化的危险因素分析

Analysis of risk factors for chronicity of primary immune thrombocytopenia in adults

目的 回顾性分析成人原发免疫性血小板减少症(ITP)患者的临床资料,探讨引起成人ITP慢性化的相关危险因素,以期找到疾病预后相关预测指标,为制定个体化治疗方案提供理论依据。方法 选择2012年1月至2022年1月包头市中心医院血液科收治的初诊为成人ITP的患者209例,收集患者的基本信息、实验室数据及治疗方案等资料,并随访1年以上。结果 研究纳入的成人ITP患者中男79例,女130例,男女比例为1∶1.64。111例在初诊后1年内获得缓解,缓解率53.11%,归入非慢性组;98例(46.89%)进展为慢性,归入慢性组。多因素logistic回归分析显示,初诊血小板(PLT)计数≥20×10^(9)/L(OR=1.82,95%CI:1.02~3.37,P=0.045)增加疾病慢性化风险,而治疗后PLT峰值高(OR=0.69,95%CI:0.48~0.98,P=0.036)降低慢性化风险。结论 成人ITP初诊PLT计数≥20×10^(9)/L慢性化风险升高,治疗后PLT峰值高慢性化风险降低。

Objective To retrospectively analyze the clinical data of adult patients with primary immune thrombocytopenia(ITP),study the relevant risk factors that cause the chronicity of adult ITP,to find predictive indicators for disease prognosis and provide a theoretical basis for formulating personalized treatment plans.Methods A total of 209 newly diagnosed adult patients with primary ITP admitted to the Hematology Department of Baotou Central Hospital from January 2012 to January 2022 were selected.The basic information,laboratory data,and treatment plans of these patients were collected,and they were followed up for more than one year.Results Among the adult ITP patients included in the study,there were 79 males and 130 females,with a male-to-female ratio of 1:1.64.111 cases achieved remission within 1 year after initial diagnosis,with a remission rate of 53.11%,and were classified as a non-chronic group.98 cases(46.89%)progressed to chronic and were classified as a chronic group.Multivariate logistic regression analysis showed that the initial PLT count≥20×10^(9)/L(OR=1.82,95%CI:1.02-3.37,P=0.045)increased the risk of chronic disease,while a high peak PLT after treatment(OR=0.69,95%CI:0.48-0.98,P=0.036)decreased the risk of chronic disease.Conclusion Adult ITP initial diagnosis PLT count≥20×10^(9)/L has an increased risk of chronicity,and a high peak PLT after treatment reduces the risk of chronicity.