山莨菪碱联合血浆置换对血栓性血小板减少性紫癜患者神经系统症状的影响

目的：观察山莨菪碱（Ani）联合血浆置换（PE）对血栓性血小板减少性紫癜（TTP）患者神经系统症状的影响。方法：选择58例伴有神经系统症状的TTP患者随机分为联合治疗组（31例）和对照组（27例）。联合治疗组患者给予PE治疗，置换剂量为40ml／（kg·d），置换频率为：第1周1次／d，第2周1次／2d，第3周1次／3d；同时给予Ani25mg／（m^2·d），加入5％葡萄糖注射液250ml中静脉滴注，持续2～2．5h。对照组患者单用PE治疗，方案同联合治疗组。两组患者疗程均为21d。观察两组患者治疗后头痛、癫痫大发作、意识障碍、语言障碍、精神异常等症状改善情况，并观察治疗期间药物相关不良反应。结果：联合治疗组患者头痛、癫痫大发作、意识障碍、语言障碍、精神异常等症状在治疗过程中消失时间显著短于对照组，差异有统计学意义（P〈0．05）。Ani相关不良反应均较轻微，可耐受。结论：Ani联合PE治疗TTP能快速改善患者的神经系统症状，且安全性较好。

Effect of Anisodamine Combined with Plasma Exchange on the Improvement of Neurological Symptoms in Patients with Thrombotic Thrombocytopenic Purpura

OBJECTIVE： To observe the effects and safety of anisodamine （Ani） combined with plasma exchange （PE） on the improvement of neurological symptoms in patients with thrombotic thrombocytopenic purpura （TTP）. METHODS： 58 TTP patients were randomized into combined treatment group （31 cases） and control group （27 cases）. Both groups were given PE with daily dose of 40 ml/（kg, d）, replacement frequency of once a day for the first week, every other day for the second week and every 3 days for the third week; combined treatment group was additionally given Ani 25 mg/（m2. d） added into 5% Glucose injection 250 ml intravenously, lasting for 2-2.5 h. Treatment course of 2 groups lasted for 21 d. Headache, epilepsia gravior, disorder of consciousness, language barrier and psychosis of 2 groups were improved after treatment, and related ADR was observed during treatment. RESULTS： The symptoms such as headache, epilepsia gravior, disorder of consciousness, language barrier and psychosis in treatment group disappeared more quickly than in control group; there was statistical significance （P〈0.05）. Ani related ADR was slight and tolerable. CONCLUSIONS： Ani combined with PE can improve neurological symptoms rapidly with good safety.