系统性红斑狼疮患者并发中重度血小板减少症的疗效观察及相关因素分析

发布时间：2018-04-05 00:17

本文选题：红斑狼疮　切入点：系统性　出处：《实用医学杂志》2017年10期

【摘要】：目的:观察系统性红斑狼疮(SLE)并发中重度血小板减少症[血小板计数(BPC)50×109/L]患者的疗效,并探讨其相关因素。方法:回顾性分析109例SLE并发中重度血小板减少症住院患者的临床特征及治疗措施。结果:109例患者中完全缓解(CR)82例(75.2%),部分缓解(PR)15例(13.8%),无效(NR)12例(11.0%)。与有效组(CR+PR)比较,无效组(NR)骨髓巨核细胞减少的发生率较高(P0.05);两组间疾病活动度指数(SLEDAI)评分,血小板相关抗体(PAIg)阳性、抗心磷脂抗体(ACA)阳性的发生率和补体(C)3、C4的水平差异均无统计学意义。甲泼尼龙(MP)冲击治疗组和大剂量激素治疗组总有效率比较,差异亦无统计学意义。结论:骨髓巨核细胞减少可能为影响SLE并发中重度血小板减少症患者疗效的不良因素。
[Abstract]:Objective: to observe the curative effect of moderate and severe thrombocytopenia (BPC 50 脳 10 9 / L) in patients with systemic lupus erythematosus (SLEs) and to explore the related factors.Methods: the clinical features and treatment of 109 patients with SLE complicated with moderate and severe thrombocytopenia were retrospectively analyzed.Results among 109 patients, 82 cases had complete remission (75.2%), 15 cases had partial remission of PRA (13.8%), and 12 cases had no response (11.0%).Compared with the effective group (CR), the incidence of bone marrow megakaryocytosis in the ineffective group was higher than that in the control group (P 0.05), and the disease activity index (SLEDAI) score and platelet associated antibody (PAIgG) were positive in the two groups.There was no significant difference in the positive rate of anticardiolipin antibody ACAA and the level of C _ 3 C _ 4.The total effective rate of methylprednisolone (MPP) group was not significantly different from that of high dose hormone group.Conclusion: bone marrow megakaryocytopenia may be an adverse factor affecting the efficacy of SLE complicated with moderate and severe thrombocytopenia.
【作者单位】：广西医科大学第一附属医院风湿免疫科;柳州市工人医院风湿免疫科;
【基金】：广西医科大学青年科学基金项目(编号:GX-MUYSF201306) 广西教育厅课题(自筹经费)项目(编号:201106LX112)
【分类号】：R558.2;R593.241

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