Rosove M H, Ho W G, Goldfinger D
Ann Intern Med. 1982 Jan;96(1):27-33. doi: 10.7326/0003-4819-96-1-27.
Platelet-inhibiting drugs have been used widely in the treatment of thrombotic thrombocytopenia purpura. Nineteen consecutive patients received various treatments including platelet inhibitors, glucocorticoid drugs, whole blood or plasma exchange transfusions, and splenectomy. During treatment with aspirin and dipyridamole in 14 patients, five died, and only one had neither new neurologic signs nor worsening thrombocytopenia. Prostacyclin in one patient was not beneficial. Serious bleeding complications, including massive upper gastrointestinal hemorrhage, epistaxes, or subarachnoid hemorrhage confirmed at autopsy, occurred in five of the 19 patients and only during treatment with aspirin and dipyridamole. We conclude that there is no evidence for the effectiveness of aspirin and dipyridamole in the treatment of thrombotic thrombocytopenic purpura and that these drugs may increase the risk of serious bleeding complications.
血小板抑制药物已广泛用于血栓性血小板减少性紫癜的治疗。19例连续患者接受了包括血小板抑制剂、糖皮质激素药物、全血或血浆置换输血以及脾切除术在内的各种治疗。在14例接受阿司匹林和双嘧达莫治疗的患者中，5例死亡，只有1例既无新的神经系统体征，血小板减少也未加重。1例患者使用前列环素无效。19例患者中有5例出现严重出血并发症，包括尸检证实的大量上消化道出血、鼻出血或蛛网膜下腔出血，且均仅发生在使用阿司匹林和双嘧达莫治疗期间。我们得出结论，没有证据表明阿司匹林和双嘧达莫对血栓性血小板减少性紫癜的治疗有效，且这些药物可能会增加严重出血并发症的风险。
