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目的探讨原发性血小板减少性紫癜的治疗方法,分析治疗效果。方法分别予以糖皮质激素、达那唑、丙种球蛋白、长春新碱、脾切除治疗。结果单独使用糖皮质激素血小板恢复正常者13例,糖皮质激素加用人丙种球蛋白血小板恢复正常者6例,血小板恢复至大于50×109/L者4例,其中有3例加用达那唑口服。激素加用长春新碱共用5例,2例有效。2例内科治疗效果不佳后行脾切除,血小板恢复至50×109/L以上。结论成人原发性血小板减少性紫癜发病机制主要是体内存在血小板抗体,抗体一方面与血小板结合被吞噬细胞破坏,另一方面抗体还可作用于骨髓巨核细胞使之产板发生障碍,治疗首糖皮质激素,可与人丙种球蛋白、达那唑、长春新碱联用,内科治疗效果不佳者可行脾切除。
Objective To investigate the treatment of idiopathic thrombocytopenic purpura and to analyze the therapeutic effect. Methods Glucocorticoid, danazol, gamma globulin, vincristine and splenectomy were given respectively. RESULTS: Thirteen patients with normal glucocorticoid platelet recovery, 6 patients with glucocorticoid plus normal gamma globulin platelet recovery, and 4 patients with platelet recovery greater than 50 × 109 / L, 3 of whom received danazol oral. Hormone plus vincristine shared 5 cases, 2 cases effective. Two cases of poor medical treatment after splenectomy, platelet recovery to 50 × 109 / L or more. Conclusion The main pathogenesis of adult primary thrombocytopenic purpura is the presence of platelet antibodies in vivo, the antibodies on the one hand and platelet binding by phagocytic cells destroyed, on the other hand the antibody can also act on the bone marrow megakaryocytes so that the plate production disorders, the treatment of the first sugar Corticosteroids, with human gamma globulin, danazol, vincristine combined with medical treatment ineffective viable splenectomy.