期刊导航

论文摘要

老年人原发免疫性血小板减少症的治疗进展

Research progress on management of immune thrombocytopenia in elderly

作者:

Author:

收稿日期:2020-03-17          年卷(期)页码:2020,43(06):548-552

期刊名称:国际输血及血液学杂志

Journal Name:International Journal of Blood Transfusion and Hematology

关键字:紫癜,血小板减少性,特发性,肾上腺皮质激素类,免疫球蛋白类,静脉内,受体,血小板生成素,老年人

Key words:Purpura, thrombocytopenic, idiopathic|Adrenal cortex hormones|Immunoglobulins, intravenous|Receptors, thrombopoietin|Elderly

基金项目:

中文摘要

原发免疫性血小板减少症(ITP)是一种由血小板抗体介导的自身免疫性出血性疾病。ITP发病率随患者年龄增长而升高,因此对老年人ITP的诊治更需予以重视。一方面,ITP老年患者合并的基础疾病较多,导致对其诊断难度增加;另一方面,以糖皮质激素和(或)静脉输注免疫球蛋白(IVIG)为基础的一线治疗方案,对ITP老年患者的疗效不佳,并且ITP老年患者易发生糖尿病、高血压、血栓和出血,以及骨质疏松等并发症。老年人ITP的二线治疗方案包括血小板生成素受体激动剂(TPO-RA)、利妥昔单抗、氨苯砜、达那唑等。脾切除术通常为ITP老年患者对其他治疗无效时的选择。笔者拟就近年老年人ITP的流行病学特征、诊断及治疗等相关研究进展进行综述,旨在为ITP老年患者的治疗提供参考。

英文摘要

Immune thrombocytopenia (ITP) is an autoimmune disease resulted from antibody-mediated destruction of platelets. Incidence of ITP increases with the age of patients, so the diagnosis and treatment of ITP in the elderly should be paid more attention. On the one hand, diagnosis is more difficult in elderly ITP patients due to increased presence of comorbidities. On the other hand, first-line treatment based on glucocorticoid and/or intravenous immunoglobulin (IVIG) is less effective in elderly patients with ITP than in younger patients, and is more likely to develop complications such as diabetes, hypertension, thrombosis and bleeding, and osteoporosis etc.. Subsequent treatment of elderly patients with ITP includes thrombopoietin receptor agonist (TPO-RA), rituximab, dapsone, and danazol, etc.. Splenectomy is generally considered as an option when other treatments fail. In order to provide reference for the treatment of elderly patients with ITP, this article reviewed the research progress on treatment of elderly patients with ITP in recent years.

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