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血小板无力症:发病机制、诊断以及当前和新兴的治疗选择。

Glanzmann's thrombasthenia: pathogenesis, diagnosis, and current and emerging treatment options.

作者信息

Solh Tia, Botsford Ashley, Solh Melhem

机构信息

Department of Physician Assistant Studies, Philadelphia College of Osteopathic Medicine, Suwanee, GA, USA.

College of Health Care Sciences, Nova Southeastern University, Orlando, FL, USA.

出版信息

J Blood Med. 2015 Jul 8;6:219-27. doi: 10.2147/JBM.S71319. eCollection 2015.

Abstract

Glanzmann's thrombasthenia (GT) is a genetic platelet surface receptor disorder of GPIIb/IIIa (ITG αIIbβ3), either qualitative or quantitative, which results in faulty platelet aggregation and diminished clot retraction. Spontaneous mucocutaneous bleeding is common and can lead to fatal bleeding episodes. Control and prevention of bleeding among patients with GT is imperative, and remains challenging. Local measures, including anti-fibrinolytic therapy, with or without platelet transfusions, used to be the mainstay of therapy. However, in recent years the use of recombinant factor VIIa (rFVIIa) has increased significantly, with excellent response rates in treating and preventing hemorrhage among GT patients. Gene therapy and stem cell transplantation offer a potential cure of this disease, but both are costly and remain experimental at this point. This manuscript offers a comprehensive review of our understanding of GT and the available treatment options.

摘要

Glanzmann血小板无力症(GT)是一种遗传性血小板表面受体疾病,涉及糖蛋白IIb/IIIa(整合素αIIbβ3)的质或量异常,导致血小板聚集功能缺陷和血块回缩减弱。自发性黏膜皮肤出血很常见,可导致致命的出血事件。控制和预防GT患者的出血至关重要,但仍具有挑战性。局部措施,包括抗纤溶治疗,无论是否输注血小板,过去一直是主要的治疗方法。然而,近年来重组凝血因子VIIa(rFVIIa)的使用显著增加,在治疗和预防GT患者出血方面有出色的有效率。基因治疗和干细胞移植为治愈这种疾病提供了可能,但两者成本高昂,目前仍处于实验阶段。本文全面综述了我们对GT的认识以及现有的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a86a/4501245/2dcfb270d8f7/jbm-6-219Fig1.jpg

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