Udvardy M
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Orvostudományi Kar, II. Belgyógyászati Klinika, Hematológia tanszék.
Orv Hetil. 2001 Dec 9;142(49):2723-30.
Immune thrombocytopenic purpura (ITP) belongs to the major classical entities of clinical haematology. Diagnosis is still based on documentation of "megakaryocytic thrombocytopenia" and exclusion of other factors, diseases. The childhood (mainly acute) and adult type (mainly chronic) seem to differ substantially, and run different prognosis as well as response to therapeutic measures. A lasting remission or cure is uncommon with corticosteroids alone in the chronic cases, so splenectomy is frequently necessary and indicated. Standard therapy is poorly defined or established in splenectomy refractory cases, which situation requires experience, therapeutic skills and special care. There are many promising efforts to spare splenectomy, especially in younger patients. New standards are also recommended in ITP crisis situations (wet purpura, pregnancy and delivery, splenectomy, etc.). Standard as well as innovative approaches, focusing on clinical care, are briefly evaluated and reviewed in this report.
免疫性血小板减少性紫癜(ITP)属于临床血液学的主要经典病种。诊断仍基于“巨核细胞性血小板减少”的记录以及其他因素、疾病的排除。儿童型(主要为急性)和成人型(主要为慢性)似乎有很大差异,预后和对治疗措施的反应也不同。在慢性病例中,仅用皮质类固醇难以实现持久缓解或治愈,因此脾切除术常常是必要且适用的。在脾切除难治性病例中,标准治疗方法定义不明确或尚未确立,这种情况需要经验、治疗技能和特别护理。有许多旨在避免脾切除术的有前景的努力,尤其是在年轻患者中。在ITP危急情况(湿性紫癜、妊娠和分娩、脾切除术等)中也推荐了新的标准。本报告简要评估和综述了侧重于临床护理的标准及创新方法。