Department of Haematology, St Georges Hospital, London, United Kingdom.
Hematology Am Soc Hematol Educ Program. 2012;2012:191-7. doi: 10.1182/asheducation-2012.1.191.
Thrombocytopenia is a common hematologic finding with variable clinical expression. A low platelet count may be the initial manifestation of infections such as HIV and hepatitis C virus or it may reflect the activity of life-threatening disorders such as the thrombotic microangiopathies. A correct identification of the causes of thrombocytopenia is crucial for the appropriate management of these patients. In this review, we present a systematic evaluation of adults with thrombocytopenia. The approach is clearly different between outpatients, who are frequently asymptomatic and in whom we can sometimes indulge in sophisticated and relatively lengthy investigations, and the dramatic presentation of acute thrombocytopenia in the emergency department or in the intensive care unit, which requires immediate intervention and for which only a few diagnostic tests are available. A brief discussion of the most common etiologies seen in both settings is provided.
血小板减少症是一种常见的血液学表现，具有不同的临床表现。血小板计数低可能是 HIV 和丙型肝炎病毒等感染的初始表现，也可能反映出危及生命的疾病（如血栓性微血管病）的活动。正确识别血小板减少症的原因对于这些患者的适当治疗至关重要。在本综述中，我们对血小板减少症的成年患者进行了系统评估。对于门诊患者，其方法明显不同，因为这些患者通常无症状，我们有时可以进行复杂且相对冗长的检查；而对于在急诊科或重症监护病房出现急性血小板减少症的患者，其表现则更为明显，需要立即进行干预，而且只有少数诊断测试可用。本文简要讨论了在这两种情况下最常见的病因。
