血浆疗法联合利妥昔单抗治疗初发获得性TTP的效果(1)
摘要：目的 探讨血浆疗法联合利妥昔单抗治疗初发获得性血栓性血小板减少性紫癜(TTP)的临床疗效。方法 选取2018年2月～2019年8月我院收治的初发获得性TTP患者64例，按照随机数字表法分为对照组和观察组，各32例。对照组给予血浆疗法治疗，观察组在对照组基础上联合利妥昔单抗治疗，比较两组临床疗效、血小板数值变化及不良反应发生情况。结果 观察组总有效率为93.75%，高于对照组的68.75%，差异有统计学意义(P<0.05);治疗第1、2、3、4周后，观察组血小板数值高于对照组，差异有统计学意义(P<0.05);两组均未发生严重不良反应。结论 血浆疗法联合利妥昔单抗治疗初发获得性TTP患者疗效确切，可有效缓解患者的临床症状，提高血小板数目，治疗安全性较高。
关键词：初发获得性TTP;血浆疗法;利妥昔单抗;血小板数值
Abstract：Objective To explore the clinical efficacy of plasma therapy combined with rituximab in the treatment of newly acquired thrombotic thrombocytopenic purpura (TTP).Methods 64 patients with newly acquired TTP admitted to our hospital from February 2018 to August 2019 were selected and divided into a control group and an observation group， each with 32 cases according to the random number table method. The control group was given plasma therapy， and the observation group combined with rituximab treatment on the basis of the control group to compare the clinical efficacy， platelet value changes and adverse reactions of the two groups.Results The total effective rate of the observation group was 93.75%， higher than that of the control group of 68.75%， the difference was statistically significant (P<0.05); after 1， 2， 3， and 4 weeks of treatment， the platelet value of the observation group was higher than that of the control group，the difference was statistically significant (P<0.05). No serious adverse reactions occurred in both groups.Conclusion Plasma therapy combined with rituximab is effective in the treatment of patients with newly acquired TTP. It can effectively alleviate the clinical symptoms of patients， increase the number of platelets， and has a high treatment safety.
血栓性血小板減少性紫癜(thrombotic thrombocytopenic purpura，TTP)是一种较为严重的血栓性、弥散性的微血管疾病，主要表现为血小板聚集消耗性降低、微血管性溶血性贫血[1]。临床根据TTP不同的发病机制，将该病分为获得性与先天性两类，先天性TTP较为少见，仅占5%，而约95%的TTP患者是由于自身ADAMTS-13的活性降低，因造血干细胞移植感染、药物、妊娠自身免疫性疾病、肿瘤等诱因造成抗ADAMTS-13的抗体形成所致[2]。该病具有发病急、病程短、预后差等特点，若发病后无法及时得到有效的治疗，病死率高达80%～90%。临床对于治疗TTP的常规疗法为血浆疗法，其可有效缓解患者的病情，改善其预后情况，但复发率较高。利妥昔单抗是治疗复发性或难治性TTP的主要措施，对初发期患者使用小剂量利妥昔单抗的治疗效果更优。本研究主要探讨血浆疗法联合利妥昔单抗治疗初发获得性TTP的临床疗效，现报道如下。
1资料与方法
1.1一般资料 选取2018年2月～2019年8月佳木斯市中心医院收治的初发获得性TTP患者64例，本研究经医院伦理委员会审批通过，患者知情同意并签署知情同意书。按随机数字表法分为对照组和观察组，各32例。对照组男18例，女14例;年龄20～65岁，平均年龄(46.53±9.82)岁;病程2～9 d，平均病程(3.56±1.22)d。观察组男17例，女15例;年龄20～62岁，平均年龄(45.69±9.36)岁;病程3～8 d，平均病程(3.21±1.09)d。两组性别、年龄、病程比较，差异无统计学意义(P>0.05)，可对比。
1.2纳入与排除标准 纳入标准：①符合《血栓性血小板减少性紫癜诊断与治疗中国专家共识(2012年版)》[3]中相关诊断标准;②初治患者。排除标准：①存在严重脏器功能疾病者;②精神异常者。, http://www.100md.com(金英)
关键词：初发获得性TTP;血浆疗法;利妥昔单抗;血小板数值
Abstract：Objective To explore the clinical efficacy of plasma therapy combined with rituximab in the treatment of newly acquired thrombotic thrombocytopenic purpura (TTP).Methods 64 patients with newly acquired TTP admitted to our hospital from February 2018 to August 2019 were selected and divided into a control group and an observation group， each with 32 cases according to the random number table method. The control group was given plasma therapy， and the observation group combined with rituximab treatment on the basis of the control group to compare the clinical efficacy， platelet value changes and adverse reactions of the two groups.Results The total effective rate of the observation group was 93.75%， higher than that of the control group of 68.75%， the difference was statistically significant (P<0.05); after 1， 2， 3， and 4 weeks of treatment， the platelet value of the observation group was higher than that of the control group，the difference was statistically significant (P<0.05). No serious adverse reactions occurred in both groups.Conclusion Plasma therapy combined with rituximab is effective in the treatment of patients with newly acquired TTP. It can effectively alleviate the clinical symptoms of patients， increase the number of platelets， and has a high treatment safety.
血栓性血小板減少性紫癜(thrombotic thrombocytopenic purpura，TTP)是一种较为严重的血栓性、弥散性的微血管疾病，主要表现为血小板聚集消耗性降低、微血管性溶血性贫血[1]。临床根据TTP不同的发病机制，将该病分为获得性与先天性两类，先天性TTP较为少见，仅占5%，而约95%的TTP患者是由于自身ADAMTS-13的活性降低，因造血干细胞移植感染、药物、妊娠自身免疫性疾病、肿瘤等诱因造成抗ADAMTS-13的抗体形成所致[2]。该病具有发病急、病程短、预后差等特点，若发病后无法及时得到有效的治疗，病死率高达80%～90%。临床对于治疗TTP的常规疗法为血浆疗法，其可有效缓解患者的病情，改善其预后情况，但复发率较高。利妥昔单抗是治疗复发性或难治性TTP的主要措施，对初发期患者使用小剂量利妥昔单抗的治疗效果更优。本研究主要探讨血浆疗法联合利妥昔单抗治疗初发获得性TTP的临床疗效，现报道如下。
1资料与方法
1.1一般资料 选取2018年2月～2019年8月佳木斯市中心医院收治的初发获得性TTP患者64例，本研究经医院伦理委员会审批通过，患者知情同意并签署知情同意书。按随机数字表法分为对照组和观察组，各32例。对照组男18例，女14例;年龄20～65岁，平均年龄(46.53±9.82)岁;病程2～9 d，平均病程(3.56±1.22)d。观察组男17例，女15例;年龄20～62岁，平均年龄(45.69±9.36)岁;病程3～8 d，平均病程(3.21±1.09)d。两组性别、年龄、病程比较，差异无统计学意义(P>0.05)，可对比。
1.2纳入与排除标准 纳入标准：①符合《血栓性血小板减少性紫癜诊断与治疗中国专家共识(2012年版)》[3]中相关诊断标准;②初治患者。排除标准：①存在严重脏器功能疾病者;②精神异常者。, http://www.100md.com(金英)