Kaplan C, Murphy M F, Kroll H, Waters A H
Service d'Immunologie Plaquettaire, I.N.T.S. Paris, France.
Br J Haematol. 1998 Jan;100(1):62-5. doi: 10.1046/j.1365-2141.1998.00533.x.
The optimal antenatal therapy for fetal thrombocytopenia has not been determined. We analysed 37 cases managed by maternal therapy and observed a successful outcome of maternal treatment in 26% of IvIgG cases and in 10% of steroid-treated cases. The significance of a plateau of the fetal platelet counts during pregnancy, 41% of IvIgG cases and 20%, of cases treated with steroids, is uncertain. It may indicate a stabilization of thrombocytopenia, hence a beneficial effect of therapy, or the natural course of the platelet count in a low-risk pregnancy. Overall outcome was unpredictable, but amongst the therapy failures there were proportionally more severely affected siblings. Further multicentre studies are necessary to establish the optimal antenatal management of high-risk pregnancies.
胎儿血小板减少症的最佳产前治疗方法尚未确定。我们分析了37例采用母体治疗的病例，观察到静脉注射免疫球蛋白（IvIgG）治疗的病例中有26%取得成功，而接受类固醇治疗的病例中这一比例为10%。孕期胎儿血小板计数出现平台期的意义尚不确定，静脉注射免疫球蛋白治疗的病例中有41%出现这种情况，接受类固醇治疗的病例中有20%出现这种情况。这可能表明血小板减少症趋于稳定，从而说明治疗有有益效果，也可能是低风险妊娠中血小板计数的自然过程。总体结果不可预测，但在治疗失败的病例中，受影响更严重的兄弟姐妹比例更高。需要进一步开展多中心研究，以确定高危妊娠的最佳产前管理方法。
