Shojaiefard A, Mousavi S A, Faghihi S H, Abdollahzade S
Department of Surgery, Shariati Hospital, School of Medicine, Medical Sciences/University of Tehran, Kargar Shomali Avenue, Tehran, Iran.
World J Surg. 2008 Mar;32(3):488-93. doi: 10.1007/s00268-007-9399-2.
Chronic immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by destruction of opsonized platelets in the reticuloendothelial system, particularly the spleen, and by resulting low platelet counts. Splenectomy is the standard second-line treatment for patients with ITP who do not respond to corticosteroids. In the present study we determined predictive factors for the response of patients with ITP to splenectomy.
For thirty-one patients with ITP referred from the Hematology Department of Shariati Hospital, open surgical splenectomy was performed between February 2002 and December 2004. All potentially important variables of response were collected and analyzed to determine predictive parameters.
Older patients (>52) responded less positively than younger patients (<52) to splenectomy (p<0.01). Likewise, patients with a sustained remission after splenectomy had a significantly shorter interval of diagnosis of ITP to splenectomy (p<0.05) and shorter duration of corticosteroid therapy before splenectomy (p<0.05).
This study confirms that splenectomy is an effective treatment for patients with ITP. Our findings highlight age as the major predictive factor of long-term response to splenectomy in patients with ITP.
慢性免疫性血小板减少性紫癜（ITP）是一种自身免疫性疾病，其特征是网状内皮系统（尤其是脾脏）中被调理素化的血小板遭到破坏，导致血小板计数降低。脾切除术是对皮质类固醇治疗无反应的ITP患者的标准二线治疗方法。在本研究中，我们确定了ITP患者对脾切除术反应的预测因素。
对于从沙里亚蒂医院血液科转诊的31例ITP患者，于2002年2月至2004年12月进行了开放性脾切除术。收集并分析所有可能影响反应的重要变量，以确定预测参数。
年龄较大（>52岁）的患者对脾切除术的反应不如年龄较小（<52岁）的患者积极（p<0.01）。同样，脾切除术后持续缓解的患者，从ITP诊断到脾切除术的间隔时间明显较短（p<0.05），脾切除术前皮质类固醇治疗的持续时间也较短（p<0.05）。
本研究证实脾切除术对ITP患者是一种有效的治疗方法。我们的研究结果突出了年龄是ITP患者脾切除术长期反应的主要预测因素。
