论文部分内容阅读
活动性结核病(TB)可伴存各种血液学异常,但成人型免疫性血小板减少性紫癜(ITP)相当罕见。作者回顾1987年1月至1994年12月间846例活动性结核的患者中9例(1％)表现ITP,作为仅有的血液学异常,同期138例ITP住院患者中9倒(6.5％)以后证实有结核。9例结核伴存ITP患者中男性2倒,女性7例,年龄28～65岁,中数年龄50岁。3/9例有弥散性粟粒性肺TB,3例腹部TB脓肿或卵巢TB及3例肺TB。最初临床表现为紫癜、牙龈出血、鼻衄、腹痛、月经过多及血尿等。无1例脾肿大。起病时血小板数1～21×10~9/L,中数11×10~9/L。9例患者均接受强的松(60～200mg/d)治疗,另加血小板输注2例。应用环磷酰胺1例无效。3例骨髓活检证实肉芽肿,最初胸部X线检查正常,应用
Active tuberculosis (TB) can be associated with a variety of hematological abnormalities, but adult-type immune thrombocytopenic purpura (ITP) is quite rare. The authors recalled that 9 (1%) of 846 active tuberculosis patients between January 1987 and December 1994 showed ITP as the only hematological abnormality, compared with 9 (138%) of 138 ITP inpatients during the same period Confirmed tuberculosis later. Among the 9 patients with tuberculosis complicated with ITP, 2 were male and 7 were female, aged from 28 to 65 years, with a median age of 50 years. 3/9 cases had diffuse miliary lung TB, 3 cases of abdomen abscess or ovarian TB and 3 cases of pulmonary TB. The initial clinical manifestations of purpura, bleeding gums, epistaxis, abdominal pain, menorrhagia and hematuria. No case of splenomegaly. On the onset of platelet count 1 ~ 21 × 10 ~ 9 / L, the median 11 × 10 ~ 9 / L. Nine patients received prednisone (60 ~ 200mg / d) treatment, plus platelet transfusion in 2 cases. 1 case of cyclophosphamide invalid. 3 cases of bone marrow biopsy confirmed granuloma, the initial chest X-ray examination, application