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诱导性血小板减少症:16例患者的回顾性研究

-induced thrombocytopenia: a retrospective study of 16 patients.

作者信息

Xie Songsong, Zhou Yan, Zheng Rongjiong, Zuo Weize, Lu Xiaobo, Wang Yuanzhi, Zhang Yuexin

机构信息

1 Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

2 The First Hospital of Shihezi University, Shihezi, Xinjiang, China.

出版信息

J Int Med Res. 2019 Jul;47(7):3008-3013. doi: 10.1177/0300060519847406. Epub 2019 Jun 3.

Abstract

OBJECTIVE

We aimed to describe the clinical characteristics and treatment outcomes of 16 patients with -induced thrombocytopenia.

METHODS

We assessed 16 patients with -induced thrombocytopenia between 2012 and 2016 in The First Affiliated Hospital of Xinjiang Medical University. The diagnosis of -induced thrombocytopenia was ≤100,000 platelets/mm.

RESULTS

All patients were men. The most common symptoms of patients were fever (100%), sweating (81.2%), fatigue (75%), and joint pain (25%). The most common signs of physical examinations were an enlarged liver (75%) and enlarged spleen (50%). The lowest thrombocyte count was 2000/mm³ and the highest count was 72,000/mm³. An agglutination test antibody was positive (≥1:160) in 12 (75%) patients with the highest antibody titer of 1:800. was isolated from blood cultures in nine (56.3%) patients. All patients were administered antimicrobial agents. The patients’ platelet counts were normal at a follow-up of 12 months.

CONCLUSION

Classical brucellosis therapy is adequate for patients with a platelet count > 20,000/mm. The five-drug regimen of doxycycline + rifampin + platelet transfusions +  corticosteroids + intravenous immunoglobulin is recommended for patients when the platelet count is < 10,000/mm. These findings have important implications for improving treatment outcome in patients with -induced thrombocytopenia.

摘要

目的

我们旨在描述16例[疾病名称未明确,原文此处有缺失]诱导性血小板减少症患者的临床特征及治疗结果。

方法

我们于2012年至2016年在新疆医科大学第一附属医院评估了16例[疾病名称未明确,原文此处有缺失]诱导性血小板减少症患者。[疾病名称未明确,原文此处有缺失]诱导性血小板减少症的诊断标准为血小板计数≤100,000/mm³。

结果

所有患者均为男性。患者最常见的症状为发热(100%)、出汗(81.2%)、疲劳(75%)和关节疼痛(25%)。体格检查最常见的体征为肝脏肿大(75%)和脾脏肿大(50%)。血小板计数最低为2000/mm³,最高为72,000/mm³。12例(75%)患者的凝集试验抗体呈阳性(≥1:160),抗体滴度最高为1:800。9例(56.3%)患者的血培养中分离出[病原体未明确,原文此处有缺失]。所有患者均接受了抗菌药物治疗。在12个月的随访中,患者的血小板计数恢复正常。

结论

对于血小板计数>20,000/mm³的患者,经典布鲁氏菌病治疗方法是足够的。当血小板计数<10,000/mm³时,建议患者采用强力霉素+利福平+血小板输注+皮质类固醇+静脉注射免疫球蛋白的五联疗法。这些发现对于改善[疾病名称未明确,原文此处有缺失]诱导性血小板减少症患者的治疗结果具有重要意义。

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本文引用的文献

8
Human brucellosis.人类布鲁氏菌病
Lancet Infect Dis. 2007 Dec;7(12):775-86. doi: 10.1016/S1473-3099(07)70286-4.
9
The new global map of human brucellosis.人类布鲁氏菌病的新全球地图。
Lancet Infect Dis. 2006 Feb;6(2):91-9. doi: 10.1016/S1473-3099(06)70382-6.

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