原发性免疫性血小板减少症合并血栓32例临床分析-东南大学学报医学版

原发性免疫性血小板减少症合并血栓32例临床分析

单位：1. 南通大学附属医院血液科, 江苏南通 226000;
2. 南通大学附属南通市第一医院, 江苏南通 226000;
3. 南通大学附属盐城市第一人民医院, 江苏盐城 224000

分类号：R558.2

出版年·卷·期（页码）：2022·41·第三期（304-307）

摘要：

目的：分析原发性免疫性血小板减少症（ITP）合并动静脉血栓患者的临床特点和危险因素。方法：回顾性分析2001年1月至2020年12月收治的2 086例ITP患者的临床资料，比较发生血栓和未发生血栓患者的差异。结果：共有32例（1.5%）患者发生血栓，发生血栓的患者合并高龄、肥胖、妊娠、心功能不全和（或）肾功能不全以及低蛋白血症的比例偏高（P值分别为0.034、0.024、0.040、0.032、0.028），且疾病相关因素中难治/复发、脾脏切除及用促血小板生成等（TPO）和（或）艾曲泊帕的患者比例也偏高（P值分别为0.030、0.039、0.046）。其它因素如性别、绝对卧床和丙种球蛋白的使用差异均无统计学意义（P>0.05）。动脉血栓和静脉血栓发生率相比，妊娠更易发生静脉血栓（P=0.030）。结论：ITP患者也是发生血栓的危险人群，与患者临床特征及治疗的因素有关。

Objective: To analyze the clinical characteristics and risk factors of thrombosis in primary immune thrombocytopenia(ITP) patients. Methods: A retrospective analysis of 2 086 patients with ITP admitted from January 2001 to December 2020 was performed. Statistical methods were then used as a means of comparing the differences between patients with thrombosis and those without. Results: Thrombosis occurred in a total of 32 patients(1.5%), among whom we found high proportions old age, obesity, pregnancy, cardiac and/or renal insufficiency, and hypoproteinemia(P=0.034, 0.024, 0.04, 0.032, 0.028). The proportion of patients with refractory/relapsed ITP who were administered TPO and/or eltrombopag was found to be relatively high(P=0.030, 0.039, 0.046). No difference was observed in other factors such as gender, strict bed rest, or IV immunoglobulin therapy(P=0.175, 0.335, 0.594). In addition, it was discovered that pregnancy was more likely to lead to the development of venous thrombosis than arterial thrombosis(P=0.030). Conclusion: ITP is a risk factor for thrombosis, which is related to the clinical characteristics of patients and their treatment.

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