CAJ | 학술논문

目的探讨抗核抗体(ANA)对成人免疫性血小板减少性紫癜(ITP)患者的临床特征及对大剂量地塞米松(Dex)疗效的影响.方法回顾性分析大剂量Dex治疗的94例(ANA阳性者26例)ITP病例资料,比较ANA阳性与阴性患者之间的临床特征及疗效的差异.结果 ANA对患者的临床特征无影响.ANA阴性ITP对大剂量Dex治疗总反应率高于ANA阳性者,但二者之间差异无显著统计学意义(P>0.1).ANA阴性ITP的完全反应(CR)率显著高于ANA阳性(P<0.001),并且ANA阴性ITP患者血小板的平均增值(109.838×109/L)显著高于ANA阳性者(49.423×109/L)(P<0.001).结论 ANA可以作为预测大剂量Dex治疗ITP疗效的有效指标,ANA阳性ITP患者对大剂量Dex治疗的初始疗效较差.
목적탐토항핵항체(ANA)대성인면역성혈소판감소성자전(ITP)환자적림상특정급대대제량지새미송(Dex)료효적영향.방법회고성분석대제량Dex치료적94례(ANA양성자26례)ITP병례자료,비교ANA양성여음성환자지간적림상특정급료효적차이.결과 ANA대환자적림상특정무영향.ANA음성ITP대대제량Dex치료총반응솔고우ANA양성자,단이자지간차이무현저통계학의의(P>0.1).ANA음성ITP적완전반응(CR)솔현저고우ANA양성(P<0.001),병차ANA음성ITP환자혈소판적평균증치(109.838×109/L)현저고우ANA양성자(49.423×109/L)(P<0.001).결론 ANA가이작위예측대제량Dex치료ITP료효적유효지표,ANA양성ITP환자대대제량Dex치료적초시료효교차.
Objective To determine the clinical significance of a positive antinuclear antibody (ANA) test on the presentation and initial response to high-dose dexamethasone(Dex) therapy in adult immune thrombocytopenic purpura (ITP).Methods The medical records of 94 patients who were diagnosed with ITP and treated with high-dose Dex were retrospectively analyzed. Of the 94 patients, only 26 had positive ANA tests. The differences of presentation and initial response between positive and negative ANA patients were compared with statistical methods. Results There was no association between the ANA and any of the patients’ characteristics at presentation. One week after treatment, the patients with positive ANA test and those with negative ANA were not significantly different in the rate of total response(P>0.1). But the rate of complete response (CR)was significantly higher for patients who had a negative ANA test (57.4%)compared to those with a positive ANA test (P<0.001). Furthermore, the average increase in platelet counts of negative ANA patients(109.838×109/L) was significantly higher compared to positive ANA patients(49.423×109/L)(P<0.001).Conclusion The ANA test could be a useful screening test that predicts initial response to high-dose Dex therapy. Patients who have positive ANA tests are expected to have lower response to high-dose Dex therapy.