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目的:对各类风湿免疫病合并血小板减少的临床特点进行探讨分析。方法:于2010年1月到2012年1月到我院进行治疗的风湿免疫病患者有292例,选择其中并发血小板减少的52例患者占17.81%作为研究对象,分析此病的发生率、血小板减少率以及出血程度,对比不同种类风湿免疫病合并血小板减少对于各临床治疗的反应。结果:研究的52例患者中有18例出现干燥综合征(34.62%)、20例出现系统性红斑狼疮(38.46%),在临床比较常见。骨髓象大部分未发现异常,产板无减少,巨核细胞成熟无障碍。病情较为严重时血小板能够降到15×109甚至达到10×109以下,引发眼、口腔以及消化道出血。临床上此类患者以干燥综合征为多见,而且激素加量,使用一般的免疫抑制剂进行治疗临床效果较差。后同时使用来氟米特进行治疗后获得了较好的疗效,血小板数量上升到50×109的水平,且自发出血的现象停止。结论:经本次的研究我们认为干燥综合征、系统性红斑狼疮以及混合性结缔组织病合并血小板减少有较高的发生率。另外需要注意的是,干燥综合征患者可能存在部分并发血小板减少及出血严重的情况,在治疗时激素加量,使用一般的免疫抑制剂进行治疗临床效果不佳,但是使用来氟米特进行治疗有显著的疗效。
Objective: To investigate and analyze the clinical features of various rheumatoid immune diseases combined with thrombocytopenia. Methods: From January 2010 to January 2012, 292 patients with rheumatoid disease who were treated in our hospital were selected. Fifty-two of 52 patients with concurrent thrombocytopenia were selected as the study subjects. The incidence of thrombocytopenia, Reduction rate and degree of bleeding compared with different types of rheumatoid immune disease combined with thrombocytopenia for each clinical response. Results: Among the 52 patients studied, there were 18 cases of Sjogren’s syndrome (34.62%) and 20 cases of systemic lupus erythematosus (38.46%), which were more common in clinic. Most of the bone marrow did not find abnormalities, no reduction of plate production, megakaryocyte maturation barrier-free. Serious illness when platelets can be reduced to 15 × 109 or even below 10 × 109, triggering eye, mouth and gastrointestinal bleeding. Clinically, such patients with Sjogren’s syndrome is more common, and hormone levels, the use of general immunosuppressive agents for treatment of clinical outcomes are poor. After using leflunomide after treatment received a better effect, the number of platelets increased to 50 × 109 levels, and spontaneous bleeding stopped. Conclusion: This study suggests that there is a high incidence of Sjogren’s syndrome, systemic lupus erythematosus and mixed connective tissue disease with thrombocytopenia. Also note that Sjogren’s syndrome patients may have some concurrent thrombocytopenia and severe bleeding in the treatment of hormone dosage, the use of general immunosuppressive agents for treatment of clinical outcomes, but the use of leflunomide treatment A significant effect.