Lichtin A E, Schreiber A D, Hurwitz S, Willoughby T L, Silberstein L E
Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia.
Arch Intern Med. 1987 Dec;147(12):2122-6.
Forty-one patients with thrombotic thrombocytopenic purpura were treated at the Hospital of the University of Pennsylvania, Philadelphia, between 1975 and 1985. Initially, early splenectomy was performed. However, since 1981, more intensive plasma exchange therapy (increase in frequency and size of exchange) has been used as the primary modality of treatment for this disorder. A reduction of the mortality rate over time has been observed. For the period 1975 to 1980, the mortality rate was 41% (seven of 17). In contrast, for the period 1981 to 1985, the mortality rate decreased to 17% (four of 24). These observations support the concept that the initial management of thrombotic thrombocytopenic purpura with intensive daily plasma exchange is associated with improved survival. The role of platelet inhibitors and corticosteroids needs yet to be defined.
1975年至1985年间，41例血栓性血小板减少性紫癜患者在费城宾夕法尼亚大学医院接受治疗。起初，采用早期脾切除术。然而，自1981年以来，更强化的血浆置换疗法（增加置换频率和量）已被用作该疾病的主要治疗方式。随着时间推移，死亡率有所降低。在1975年至1980年期间，死亡率为41%（17例中有7例）。相比之下，在1981年至1985年期间，死亡率降至17%（24例中有4例）。这些观察结果支持了这样一种观念，即采用每日强化血浆置换对血栓性血小板减少性紫癜进行初始治疗与生存率提高相关。血小板抑制剂和皮质类固醇的作用尚待确定。
