CAJ | 학술논문

目的：探讨血小板变化在山莨菪碱联合血浆置换治疗血栓性血小板减少性紫癜（TTP）中的临床意义。方法将本院收治的78例 TTP 患者随机分为2组，每组39例。研究组给予山莨菪碱联合血浆置换治疗，对照组仅给予血浆置换治疗，疗程均为21 d。观察2组治疗前及治疗后第2、5、12、21天血小板计数的变化及不良反应发生情况，并比较临床疗效。结果研究组治愈率显著高于对照组，且总有效率有高于对照组的趋势。治疗后第2、5、12、21天，2组血小板计数均较治疗前明显增多；治疗后第2、5、12天，研究组血小板计数显著多于对照组，差异有统计学意义。治疗期间，2组均未见严重不良反应。结论血浆置换联合山莨菪碱能有效加速 TTP 患者血小板的恢复，减少血小板消耗及微血栓形成，疗效显著，且安全性较好。
목적：탐토혈소판변화재산랑탕감연합혈장치환치료혈전성혈소판감소성자전（TTP）중적림상의의。방법장본원수치적78례 TTP 환자수궤분위2조，매조39례。연구조급여산랑탕감연합혈장치환치료，대조조부급여혈장치환치료，료정균위21 d。관찰2조치료전급치료후제2、5、12、21천혈소판계수적변화급불량반응발생정황，병비교림상료효。결과연구조치유솔현저고우대조조，차총유효솔유고우대조조적추세。치료후제2、5、12、21천，2조혈소판계수균교치료전명현증다；치료후제2、5、12천，연구조혈소판계수현저다우대조조，차이유통계학의의。치료기간，2조균미견엄중불량반응。결론혈장치환연합산랑탕감능유효가속 TTP 환자혈소판적회복，감소혈소판소모급미혈전형성，료효현저，차안전성교호。
Objective To explore the clinical significance of platelet changes in thrombotic thrombocytopenic purpura (TTP)patients by treatment of anisodamine combined with plasma ex-change.Methods 78 patients with TTP were randomly divided into two groups,39 cases in each group.The research group was treated with anisodamine combined with plasma exchange,while the control group was treated only with plasma exchange.Changes of platelet counts before treatment and on days 2,5,12 and 21 after treatment as well as incidence of adverse reactions were observed in two groups.Clinical efficacy was compared.Results In the research group,healing rate was significantly higher and overall response rate was slightly higher than control group.On days 2,5, 12 and 21 after treatment,the platelet counts in both groups increased obviously.On days 2,5 and after treatment,the platelet count in research group was significantly greater than in control group. During treatment,no severe adverse reactions were observed in both groups.Conclusion Aniso-damine combined with plasma exchange can effectively accelerate the recovery of platelets in patients with TTP,reduce platelet consumption and microthrombosis and shows a significant efficacy and better safety.