Fabris F, Zanatta N, Casonato A, Randi M L, Luzzatto G, Girolami A
University of Padua Medical School, Institute of Medical Semeiotics, Padova, Italy.
Acta Haematol. 1989;81(1):28-33. doi: 10.1159/000205407.
Sixteen patients with chronic idiopathic thrombocytopenic purpura underwent splenectomy after failure of steroid therapy. The average time of follow-up was 69 months. Immediately after splenectomy, complete response (platelets above 150 x 10(9)/l) was obtained by 68% of patients while 25% had partial response (platelets from 50 to 150 x 10(9)/l) and only in 1 patient splenectomy failed. During the long-term follow-up, 2 patients relapsed 9 and 20 years, respectively, after splenectomy (20% of non-responders). Partial recurrence of thrombocytopenia (partial response) was observed in 33% of the patients. The persistent complete response rate was then 47%. The young patient age appears to be the only positive predictive factor both for short-term and long-term response to splenectomy. The platelet recovery rate and postsplenectomy thrombocytosis are also early features of lasting response. Positive serum and platelet-associated immunoglobulins became negative after splenectomy, but there is no correlation with clinical response.
16例慢性特发性血小板减少性紫癜患者在激素治疗失败后接受了脾切除术。平均随访时间为69个月。脾切除术后立即有68%的患者获得完全缓解（血小板计数高于150×10⁹/L），25%的患者有部分缓解（血小板计数为50至150×10⁹/L），只有1例患者脾切除失败。在长期随访中，分别有2例患者在脾切除术后9年和20年复发（占无反应者的20%）。33%的患者观察到血小板减少部分复发（部分缓解）。持续完全缓解率为47%。年轻患者年龄似乎是脾切除术短期和长期反应的唯一阳性预测因素。血小板恢复率和脾切除术后血小板增多也是持久反应的早期特征。脾切除术后血清和血小板相关免疫球蛋白阳性转为阴性，但与临床反应无关。
