Mitus A J, Barbui T, Shulman L N, Rosenthal D S, Viero P, Cortelazzo S, Schafer A I
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Am J Med. 1990 Apr;88(4):371-5. doi: 10.1016/0002-9343(90)90491-u.
The purpose of this study was to determine the incidence of hemostastic complications in young patients with essential thrombocythemia (ET).
The clinical course of 44 patients under the age of 45 with the diagnosis of ET was reviewed in a retrospective manner. Patients were collected from three medical centers in the United States and Italy: the Brigham and Women's Hospital and the Harvard Community Health Plan, Boston, Massachusetts, and the Ospedali Riuniti di Bergamo, Bergamo, Italy.
The overall incidence of hemorrhage or thrombosis, or both, in this group of patients was 39% (17 of 44), with serious complications occurring in 23% (10 of 44). Two patients died of thrombotic events. Neither the presence of symptoms at diagnosis nor any single laboratory parameter proved predictive of clinical sequelae. Treatment with antiplatelet drugs or platelet-lowering agents was not protective.
We conclude that ET in young patients may result in serious and life-threatening hemostatic problems and consequently that young age is not a favorable prognostic factor in this disease.
本研究旨在确定年轻原发性血小板增多症(ET)患者止血并发症的发生率。
对44例年龄在45岁以下诊断为ET的患者的临床病程进行回顾性分析。患者来自美国和意大利的三个医疗中心:马萨诸塞州波士顿的布里格姆妇女医院和哈佛社区健康计划,以及意大利贝加莫的贝加莫联合医院。
该组患者出血或血栓形成或两者兼有的总体发生率为39%(44例中的17例),严重并发症发生率为23%(44例中的10例)。两名患者死于血栓事件。诊断时的症状存在与否或任何单一实验室参数均不能预测临床后遗症。使用抗血小板药物或降低血小板药物治疗并无保护作用。
我们得出结论,年轻ET患者可能会导致严重且危及生命的止血问题,因此年轻并非该疾病的有利预后因素。