CAJ | 학술논문

目的：总结以神经系统症状首发的血栓性血小板减少性紫癜(thrombotic thrombocytopenic purpura,TTP)的临床特点,提高其诊断水平。方法回顾性分析我院确诊的3例TTP患者的病历资料,并复习相关文献。结果 TTP经典的五联征为发热、血小板减少性紫癜、微血管病性溶血、神经系统症状及肾损害。以脑损害为首发表现的 TTP 容易被误诊为脑卒中、颅内感染等。早期行血浆置换治疗效果好。结论以神经系统症状首发的血栓性血小板减少性紫癜临床表现复杂,容易误诊,要注意早期诊断和早期治疗。
목적：총결이신경계통증상수발적혈전성혈소판감소성자전(thrombotic thrombocytopenic purpura,TTP)적림상특점,제고기진단수평。방법회고성분석아원학진적3례TTP환자적병력자료,병복습상관문헌。결과 TTP경전적오련정위발열、혈소판감소성자전、미혈관병성용혈、신경계통증상급신손해。이뇌손해위수발표현적 TTP 용역피오진위뇌졸중、로내감염등。조기행혈장치환치료효과호。결론이신경계통증상수발적혈전성혈소판감소성자전림상표현복잡,용역오진,요주의조기진단화조기치료。
Objective To summarize the clinical characteristics of thrombotic thrombocytopenic purpura(TTP)presen-ting neurological manifestations as initial symptoms and improve the diagnostic level.Methods Clinical data of 3 cases of TTP were retrospective analyzed with literatures review.Results Fever,microvascular platelet clumping resulting in thrombocytopenia,microangiopathic hemolysis,neurological abnormality,and renal dysfunction were the characteristics of TTP.The initial symptom shown as neurological disfunction was easily misdiagnosed as stroke and intracranial infection. Early plasma exchange therapy should be effective.Conclusions The TTP presenting neurological manifestations as initial symptoms is easily misdiagnosed and should be early diagnosed and treated.