风湿免疫病并发血小板减少76例临床分析

目的了解各类风湿免疫病并发血小板减少的临床特点。方法分析76例风湿免疫病并发血小板减少的发生率、血小板减少及出血程度和不同种类风湿免疫病并发血小板减少对各种治疗的反应。结果 76例风湿免疫病并发血小板减少患者中以系统性红斑狼疮(38.1%)、干燥综合征(32.9%)较常见。一般表现为皮肤瘀斑。骨髓象绝大多数无异常,巨核细胞成熟无障碍,血小板无减少。严重时血小板可降至15×109甚至10×109以下。出现眼、口腔甚至消化道出血,且激素加量、一般免疫抑制剂等治疗效果差。加用来氟米特后获得较好疗效,血小板升至50×109水平,自发出血停止。结论系统性红斑狼疮、干燥综合征、混合性结缔组织病并发血小板减少发生率较高。值得注意的是,干燥综合征中部分可并发显著血小板减少及出血严重,激素加量及一般免疫抑制剂治疗效果可能不佳,而来氟米特疗效较好。

Clinical analysis of rheumatological disease complicated by thrombocytopenia:on 76 cases report

Objective To understand the clinical feature of various rheumatological disease complicated by thrombocytopenia. Methods Analysed the incidence of rheumatological disease complicated by thrombocytopenia, the degree of thrombocytopenia and reduce bleeding and different type of rheumatological disease complicated by thrombocytopenia with response to a variety of treatment in 76 cases patients. Results In 76 cases patients with rheumatological disease complicated by thrombocytopenia, systemic lupus erythematosus（ 38.1% ）, sjogren syndrome （32.9%） were more common. Usually manifested as skin ecchymosis. The vast majority of bone marrow figure no abnormal megakaryocyte maturation barrier-free plate production without reducing. Severe platelet can be reduced to 15 - 109 or even 10- 109 below. The eyes, the mouth or gastrointestinal bleeding,and the hormone plus the amount of immunosuppressant treatment. After leflunomide good effect, platelets rose to 50 - 109, spontaneous bleeding stopped. Conclusion Systemic lupus erythematosus, sjogren syndrome, mixed connective tissue disease complicated by thrombocytopenia have a higher incidence. It is noteworthy that, sjogren syndrome, the part may be complicated by significant thrombocytopenia and severe bleeding, hormone dosage and immunosuppressant treatment may be poor, while leflunomide good effect.