Freedman J, Garvey M B, Elinder G, Blanchette V S
St Michael's Hospital, University of Toronto, Ontario, Canada.
Acta Paediatr Suppl. 1998 Jun;424:82-4. doi: 10.1111/j.1651-2227.1998.tb01241.x.
All attendees participated in a round-table discussion regarding directions for research in autoimmune thrombocytopenic purpura (ITP). Suggested areas for study were grouped into five main areas: (i) improved classification of ITP identifying subsets of patients with differing clinical syndromes and response to treatment, and those more likely to have serious bleeding manifestations; identification of patients with reduced thrombopoiesis was emphasized; (ii) studies aimed at elucidating the aetiology and pathophysiology of ITP, with emphasis on distinctions between acute and chronic ITP and between patients responsive or refractory to therapy; these studies focused on measures of humoral and cellular immune dysregulation; (iii) studies of platelet function in ITP, with the intent of defining these abnormalities and correlating them with the clinical manifestations of the disease; (iv) new approaches to treatment, particularly of refractory patients; and (v) a miscellaneous group, which included development of an ITP registry, evaluation of the "burden" of disease, investigation of mood changes in ITP, etc. The discussion was not intended to be all-inclusive, but focused on the content of other talks in this symposium. It is hoped that some of these suggestions will be further developed for investigation in multicentre co-operative studies to improve the diagnosis, understanding and treatment of ITP.
所有与会者参加了关于自身免疫性血小板减少性紫癜（ITP）研究方向的圆桌讨论。建议的研究领域分为五个主要方面：（i）改进ITP的分类，识别具有不同临床综合征和对治疗反应的患者亚组，以及那些更有可能出现严重出血表现的患者；强调识别血小板生成减少的患者；（ii）旨在阐明ITP病因和病理生理学的研究，重点是区分急性和慢性ITP以及对治疗有反应或难治的患者；这些研究集中在体液和细胞免疫失调的测量上；（iii）ITP中血小板功能的研究，旨在确定这些异常并将其与疾病的临床表现相关联；（iv）治疗的新方法，特别是针对难治性患者的方法；（v）一个杂项组，包括建立ITP登记册、评估疾病“负担”、调查ITP中的情绪变化等。此次讨论并非旨在涵盖所有内容，而是围绕本次研讨会其他演讲的内容展开。希望其中一些建议将在多中心合作研究中进一步展开调查，以改善ITP的诊断、认识和治疗。
