Rocco M V, Stein R S
South Med J. 1984 Aug;77(8):983-7. doi: 10.1097/00007611-198408000-00012.
The prognostic factors for splenectomy response were evaluated in 40 adult patients with idiopathic thrombocytopenic purpura (ITP). We defined the corticosteroid response on the basis of the platelet count after seven to ten days of therapy, rather than at some time after discontinuing corticosteroid agents, as previously reported in the literature. Initial corticosteroid response was statistically significant in predicting splenectomy response; age and sex were marginally significant; duration of symptoms and spleen weight were not predictive. Of 30 patients with a minor or complete response to corticosteroids, 28 (93%) responded to splenectomy; of ten patients unresponsive to corticosteroids only four (40%) responded to splenectomy (P less than .001). Eighty-two percent of the patients in the complete responder group are projected to be continually relapse-free at 96 months. Only one of the patients in this group died; the nonresponders to splenectomy had a median survival of only ten months.
对40例成人特发性血小板减少性紫癜（ITP）患者脾切除术反应的预后因素进行了评估。我们根据治疗7至10天后的血小板计数来定义皮质类固醇反应，而不是像文献中先前报道的那样在停用皮质类固醇药物后的某个时间点。初始皮质类固醇反应在预测脾切除术反应方面具有统计学意义；年龄和性别具有边际显著性；症状持续时间和脾脏重量无预测性。在对皮质类固醇有轻微或完全反应的30例患者中，28例（93%）对脾切除术有反应；在对皮质类固醇无反应的10例患者中，只有4例（40%）对脾切除术有反应（P小于0.001）。完全缓解组中82%的患者预计在96个月时持续无复发。该组中只有1例患者死亡；脾切除术无反应者的中位生存期仅为10个月。
