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免疫性血小板减少症潜在病因的评估:十年经验

Assessment of the underlying causes of the immune thrombocytopenia: Ten years experience.

作者信息

Dal Mehmet Sinan, Karakus Abdullah, Dal Tuba, Aydin Berrin Balik, Hattapoglu Elif, Ekmen Mehmet Onder, Ulas Turgay, Ayyildiz Orhan

机构信息

Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Education and Research Hospital, Ankara, Turkey.

Department of Hematology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey.

出版信息

J Pak Med Assoc. 2017 Jul;67(7):1004-1008.

Abstract

OBJECTIVE

Immune thrombocytopenia (ITP) is an immune haematologic disorder causing platelet destruction mediated by anti-platelet antibodies. In this study we aimed to evaluate the clinical and laboratory variables of ITP patients in southeast of Turkey.

METHODS

In this retrospective study 167 ITP patients between 2005 and 2015 were evaluated. All patients were screened for immunological parameters including ANA (antinuclear antibodies), anti dsDNA (anti-double-stranded-DNA), ACA(anti-cardiolipin) IgM and IgG, LA (lupus anticoagulants). All patients were screened for Helicobacter pylori, HBsAg (Hepatitis B surface antigen), anti-HCV (hepatitis C virus antibody), and anti-HIV ½ (HIV antibody) and brucellosis..

RESULTS

Among the patients, 50 (29.9%) patients were male, 117 (70.1%) were female. The age range of patients was 18-86 (mean 38.16±14). In 56 patients (33.5%) splenectomy was performed. 36 patients (21.6%) were positive for ANA, 5 (3%) were positive for anti dsDNA, 14 (8.4%) for ACA Ig G, and 14 (8.4%) patients for ACA IgM. LA was tested in 165 patients and 30 (18%) patients were positive for LA. Microbiologic evaluation was as follows: 16 patients (9.6%) were positive for HbsAg, 109 (65.3%) positive for Anti-HBs, 5 positive for anti-HCV (3%), 56 (33.5%) patients were positive for Helicobacter pylori antigen, 5 (2.9%) for Brucella and one patient was positive for anti-HIV ½.

CONCLUSIONS

Immune thrombocytopenia patients have to be evaluated according to their demographic characteristics and laboratory results. Secondary causes of ITP were HIV, HCV, Helicobacter pylori, brucellosis, tuberculosis, and autoimmune diseases in our region. Management of ITP patients can change in different regions.

摘要

目的

免疫性血小板减少症(ITP)是一种免疫血液系统疾病,由抗血小板抗体介导血小板破坏。在本研究中,我们旨在评估土耳其东南部ITP患者的临床和实验室变量。

方法

在这项回顾性研究中,对2005年至2015年间的167例ITP患者进行了评估。所有患者均接受免疫参数筛查,包括抗核抗体(ANA)、抗双链DNA(抗dsDNA)、抗心磷脂抗体(ACA)IgM和IgG、狼疮抗凝物(LA)。所有患者均接受幽门螺杆菌、乙肝表面抗原(HBsAg)、丙肝病毒抗体(抗-HCV)、艾滋病毒抗体(抗-HIV ½)及布鲁氏菌病筛查。

结果

患者中,50例(29.9%)为男性,117例(70.1%)为女性。患者年龄范围为18 - 86岁(平均38.16±14岁)。56例(33.5%)患者接受了脾切除术。36例(21.6%)ANA阳性,5例(3%)抗dsDNA阳性,14例(8.4%)ACA IgG阳性,14例(8.4%)ACA IgM阳性。对165例患者进行了LA检测,30例(18%)患者LA阳性。微生物学评估结果如下:16例(9.6%)HBsAg阳性,109例(65.3%)抗-HBs阳性,5例(3%)抗-HCV阳性,56例(33.5%)患者幽门螺杆菌抗原阳性,5例(2.9%)布鲁氏菌阳性,1例患者抗-HIV ½阳性。

结论

免疫性血小板减少症患者必须根据其人口统计学特征和实验室结果进行评估。在我们地区,ITP的继发原因包括艾滋病毒、丙肝病毒、幽门螺杆菌、布鲁氏菌病、结核病和自身免疫性疾病。不同地区ITP患者的管理可能会有所不同。

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