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目的了解Graves病合并免疫性血小板减少症(ITP)患者的临床特征及治疗效果的特点。方法将山东大学齐鲁医院2002年7月至2009年8月收治的患者分为Graves病合并ITP(合并组)、单纯Graves病(GD组)、单纯ITP(ITP组)各25例,比较分析3组患者的各项临床指标及治疗效果的特征。结果合并组患者出血症状的发生率明显低于ITP组,而其游离三碘甲状腺原氨酸(FT3)水平明显高于GD组患者。比较合并组及ITP组血常规结果,外周血白细胞、血红蛋白、血小板计数(PLT)三者的差异均有统计学意义,显示合并组患者的血象三系均有轻微下降,但PLT的下降不如ITP组明显。合并组及ITP组血小板减少的治疗,近期有效(CR+R)率近似,而近期完全缓解率分别为68%及32%,差异明显。结论Graves病合并ITP在年长的患者中更易发生。患者的临床表现与实验室检查结果之间并不一致,存在很大的个体差异性。合并血小板减少的Graves病患者的FT3水平更高,其机制尚需分子生物学证据来解释。
Objective To understand the clinical characteristics and therapeutic effects of patients with Graves’ disease and immune thrombocytopenia (ITP). Methods The patients admitted to Qilu Hospital of Shandong University from July 2002 to August 2009 were divided into Graves ’disease (ITP group), 25 cases of Graves’ disease (GD group) and 25 cases of ITP group (ITP group) Group of patients with various clinical indicators and the characteristics of the treatment effect. Results The incidence of hemorrhagic symptoms in the combined group was significantly lower than that in the ITP group, while the free triiodothyronine (FT3) level was significantly higher in the combined group than in the GD group. Comparing the blood routine results of the combined group and ITP group, the differences of peripheral blood leucocyte, hemoglobin and platelet count (PLT) were statistically significant, showing that the blood group three patients had a slight decrease, but the decline of PLT was not as good as ITP Group obvious. The treatment of thrombocytopenia in the combined group and the ITP group was similar in recent effective (CR + R) rates, and the recent complete response rates were 68% and 32%, respectively, with significant differences. Conclusions Graves’ disease with ITP is more likely to occur in elderly patients. The patient’s clinical manifestations and laboratory findings are not the same, there is a great deal of individual differences. FT3 levels in patients with Graves disease with thrombocytopenia are higher, and the mechanism remains to be elucidated by molecular biological evidence.