免疫性血小板减少性紫癜的发病机制与临床研究进展

免疫性血小板减少性紫癜(Immune thrombocytopenic purpura,ITP)是自身抗体介导的血小板减少综合征,自身抗原的主要成分是血小板一种或多种糖蛋白;细胞免疫也是血小板破坏的一个重要原因.目前ITP的诊断仍是临床排除性诊断,分为原发性与继发性两种.ITP治疗的目的是使患者血小板计数提高到安全水平.肾上腺糖皮质激素仍是ITP的首选药物,静脉输注丙种球蛋白(IVIg)用于控制严重出血与重度血小板减少,脾切除仍是治疗慢性ITP的主要手段.血小板生成素(TPO)类似物可能成为新的治疗方法.对成人慢性ITP患者应常规进行幽门螺杆菌(Hp)筛查,阳性患者应根除Hp.

Advances in pathogenetic and clinical research of immune thrombocytopenic purpura

Immune thrombocytopenic purpura (ITP) is characterized by autoantibody-mediated thrombocytopenia,with the major autoantigens being platelet glycoproteins.Cellular immunity is also involved in platelet destruction.ITP remains a diagnosis of exclusion,defined as primary and secondary ITP.The major goal for its treatment is to provide a safe platelet count.Corticosteroid-based regimens are commonly used as the initial treatment,and severe patients have temporary responses to intravenous immunoglobulin.Splenenectomy shows curative-potential in some chronic ITP cases.Thrombopoietic agents would become a new approach of treatment.Helicobacter pylori (H.pylori) infection should be screened in adult chronic ITP,and when the result is positive,H.pylori eradication therapy is indicated.