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免疫性血小板减少症合并肺血栓栓塞症:5例报告及文献复习

Pulmonary Thromboembolism in Immune Thrombocytopenia: A Report of Five Cases and a Review of the Literature.

作者信息

Tan Yong, Yan Min, Cheng Zhen, Pan Xiangtao

机构信息

Department of Haematology, The Taicang Hospital Affiliated of Soochow University, Taicang, 215400, Jiangsu, People's Republic of China.

出版信息

Int J Gen Med. 2021 Aug 13;14:4479-4483. doi: 10.2147/IJGM.S323146. eCollection 2021.

Abstract

OBJECTIVE

To provide a reference for the diagnosis and treatment of patients with immune thrombocytopenia (ITP) complicated with pulmonary thromboembolism (PTE) by analyzing the clinical characteristics of five such patients.

METHODS

This paper summarizes the clinical manifestations and hematological indexes of five patients with ITP complicated with pulmonary embolism.

RESULTS

In this study, the incidence of ITP complicated with PTE was 2.75%. All five cases were elderly patients with nonspecific clinical manifestations. Platelet counts were different when PTE occurred. The time from the diagnosis of ITP to the occurrence of PTE was from 5 to 24 months, with an average of 12.8 months. There was no significant change in hemoglobin, white blood cell levels, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen levels, or the international normalized ratio. Four patients had significantly increased D-dimer levels, while D-dimer was only slightly increased in one patient. Antithrombin (AT) was significantly decreased in four cases (less than 70%), and C-reactive protein (CRP) was increased in all five cases.

CONCLUSION

PTE may be related to AT and CRP in patients with ITP, which is of great clinical significance to the diagnosis and treatment of ITP complicated with PTE.

摘要

目的

通过分析5例免疫性血小板减少症(ITP)合并肺血栓栓塞症(PTE)患者的临床特征,为ITP合并PTE患者的诊断和治疗提供参考。

方法

本文总结了5例ITP合并肺栓塞患者的临床表现和血液学指标。

结果

本研究中,ITP合并PTE的发生率为2.75%。所有5例均为老年患者,临床表现不具有特异性。发生PTE时血小板计数各不相同。从ITP诊断到发生PTE的时间为5至24个月,平均为12.8个月。血红蛋白、白细胞水平、凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原水平或国际标准化比值均无显著变化。4例患者D-二聚体水平显著升高,1例患者D-二聚体仅略有升高。4例抗凝血酶(AT)显著降低(低于70%),5例C反应蛋白(CRP)均升高。

结论

ITP患者发生PTE可能与AT和CRP有关,这对ITP合并PTE的诊断和治疗具有重要临床意义。

相似文献

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[Clinical features of patients with venous thromboembolism: 177 case analysis in 10 years].[静脉血栓栓塞症患者的临床特征:10年177例病例分析]
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019 Apr;31(4):453-457. doi: 10.3760/cma.j.issn.2095-4352.2019.04.016.

本文引用的文献

7
Is ITP a thrombophilic disorder?ITP 是否为血栓形成倾向疾病?
Am J Hematol. 2016 Jan;91(1):39-45. doi: 10.1002/ajh.24234. Epub 2015 Nov 26.
9
Thrombophilia in patients with chronic immune thrombocytopenia.慢性免疫性血小板减少症患者的血栓形成倾向
Scand J Clin Lab Invest. 2015 Jan;75(1):13-7. doi: 10.3109/00365513.2014.962597. Epub 2014 Oct 9.

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