免疫 Thrombocytopenia

迹象 & 症状

ITP最常见的症状是瘀点(皮肤上的红色或紫色点)。, bruising and bleeding. When ITP is severe and the platelet count is less than 10,000, 患者通常会注意到瘀点和瘀伤，很少接触.

出血可以发生在任何地方，但最典型的是在鼻子、嘴巴和肠道. Women often notice excessive menstrual bleeding. 很少, but most dangerously, people with ITP can develop bleeding in the brain, which can be life-threatening.

诊断

当其他方面健康的患者出现血小板计数低的症状时，可怀疑ITP, or is found to have a low platelet count on a routine complete blood count (CBC) test.

There is no one specific test to prove a patient has ITP. 相反，ITP是通过排除血小板计数低的其他原因来诊断的. This includes making sure that the person does not have:

• 艾滋病毒感染
• Hepatitis C infection
• Vitamin B12 or folate deficiencies
• 由于血小板在采血管中结块而造成的假的低血小板计数

对于某些个体，可以进行额外的测试以排除:

• Helicobacter pylori infection
• Viral infections
• Myelodysplastic syndrome (especially if the patient is over the age of 60)

偶尔, certain medications (including some over-the-counter medications), pregnancy or medical conditions, such as immune disorders or infections, will be associated with ITP. However, there is often no identifiable disease associated with ITP.

治疗

Treatment is considered for patients who have:

• A platelet count less than 30,000
• 即将进行的手术或程序，需要他们有更高的血小板计数
• Active bleeding with a known diagnosis of ITP

If treatment is necessary, the most common treatments include:

• 皮质类固醇(“类固醇”)-类固醇通过减少血小板抗体的产生来防止出血. 如果有效，血小板计数将在开始使用类固醇的两到四周内上升. Side effects include irritability, stomach irritation, 体重增加, difficulty sleeping, mood changes and acne.
• 静脉注射丙种球蛋白(“IVIg”)- IVIg可以暂时减缓血小板破坏的速度. IVIg起效很快——在24到48小时内——但它的效果通常只持续几天到几周.

如初步治疗无效，可尝试以下治疗方法:

• 利妥昔单抗(“利妥昔单抗”)-一种专门针对免疫系统细胞类型的抗体，可以产生针对血小板的抗体. This therapy may require up to four weekly infusions. 对治疗的反应通常在第一次输注后的4至6周内出现, although it can take longer.
• 仿血小板生成素(Eltrombopag/“Promacta”和Romiplostim/“Nplate”)-这些药物增加骨髓中血小板的生成. 美国食品和药物管理局最近批准它们用于对类固醇无效的患者. They generally work well to increase the platelet count.
• 脾切除术 — 脾切除术 is the surgical removal of the spleen, 大部分抗体结合的血小板从血液中移除的位置. 这可能是ITP患者的有效和永久的解决方案, 但他们将来会面临某些感染的风险.

此外，ITP患者可能需要改变生活方式，包括:

• Limiting participation in contact sports, such as football, boxing and martial arts, and other sports that can increase the risk of head injury, including skiing, snowboarding and motorbike racing.
• 接受脾切除术的患者必须在家中使用未过期的抗生素，以防出现感染的体征或症状, such as a fever and greenish mucus. 出现这些症状的患者必须通知他们的十大赌博平台排行榜，以获得是否服用抗生素的指示.
• Avoiding over-the-counter, 可以降低血小板功能的草药或处方药. 这些药物包括但不限于阿司匹林、布洛芬、萘普生和香豆丁.