Mayer Beate, Salama Abdulgabar
Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Vox Sang. 2017 Nov;112(8):767-772. doi: 10.1111/vox.12549. Epub 2017 Sep 26.
The clinical significance of immune thrombocytopenia (ITP) is mainly reflected by bleeding and/or bleeding risks, which, in some cases, cannot be adequately controlled by standard therapy. Tranexamic acid (TA) is increasingly used in preventing and reducing bleeding in several medical settings. There is little information on whether TA may also be useful in the management of ITP.
Twelve patients with ITP were treated with TA (0·5-3 g/day) due to recognizable bleeding. Ten of the 12 patients were under regular treatment for ITP. The remaining two patients did not require additional therapy.
Cessation or, at least, significant improvement of bleeding was achieved shortly after the initiation of TA in all cases. TA was well tolerated and discontinued after cessation of bleeding.
We recommend the use of TA in ITP patients with bleeding and/or an increased bleeding risk. Ultimately, cessation of bleeding plays a key role in the management of such affected patients. However, future studies are required to optimize dose and administration routes (intravenous or oral).
免疫性血小板减少症（ITP）的临床意义主要体现在出血和/或出血风险上，在某些情况下，标准治疗无法充分控制这些情况。氨甲环酸（TA）在多种医疗场景中越来越多地用于预防和减少出血。关于TA在ITP管理中是否也有用的信息很少。
12例ITP患者因可识别的出血接受TA治疗（0.5 - 3克/天）。12例患者中有10例正在接受ITP的常规治疗。其余2例患者不需要额外治疗。
所有病例在开始使用TA后不久出血停止或至少有显著改善。TA耐受性良好，出血停止后停药。
我们建议对有出血和/或出血风险增加的ITP患者使用TA。最终，出血的停止在这类患者的管理中起关键作用。然而，未来需要研究来优化剂量和给药途径（静脉或口服）。
