老年原发免疫性血小板减少症诊治进展

Update on the diagnosis and treatment of elderly primary immunological thrombocytopenia

原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)是一种因体液免疫和细胞免疫异常的自身免疫性疾病,主要临床表现为皮肤、黏膜、内脏等出血,同时伴有疲劳、焦虑、抑郁等症状。老年ITP是指发病年龄>60岁的ITP患者。儿童ITP患者往往起病较为迅疾,但是好转快,且有自愈倾向;而老年ITP患者除具有成年ITP患者多发展为慢性疾病的特点,同时还有合并症较多、多合并用药和疗效较差的特点。

Primary immune thrombocytopenia(ITP)is an autoimmune hemorrhagic disease caused by failure of immune tolerance.The incidence of this disease in adults is 5 to 10/10 million and tends to increase with age.With the development of aging society and increasing life expectancy,the diagnosis and treatment of elderly ITP patients will become a problem that cannot be ignored by clinicians.At present,the diagnosis of elderly ITP is mainly based on exclusive diagnosis,especially excluding malignant hematological diseases and connective tissue diseases such as myelodysplastic syndrome.In treatment,elderly patients with ITP often get poor effect than nonelderly patients,and long-term use of drugs in elderly patients with ITP will have more obvious adverse events,making the clinical use of some drugs limited.Based on the characteristics of difficulty in diagnosis and therapy of elderly ITP,this paper intends to explore the diagnosis and treatment of elderly ITP,in order to provide theoretical basis for clinical treatment.