脾切除治疗特发性血小板减少性紫癜的疗效观察及预后因素分析  

The clinical observations and analysis of predictive factors for splenectomy in the treatment of idiopathic thrombocytopenic purpura

作　　者：林晓骥[1] 姚荣欣[1] 朱宝玲[1] 林颖[1] 

机构地区：[1]温州医学院附属第二医院血液科,浙江温州325000

出　　处：《临床血液学杂志》2011年第3期270-272,共3页Journal of Clinical Hematology

摘　　要：目的:评价脾切除治疗特发性血小板减少性紫癜(ITP)的治疗效果,探讨影响脾切除治疗ITP预后的相关因素。方法:对52例ITP患者进行回顾性分析,应用SPSS统计软件首先做单因素分析,将单因素分析后P<0.05的预后因素进行Logistic回归分析,筛选出独立的预后因素。结果:本组52例患者随访4～118个月,67.3%患者获得显效,17.3%为良效,15.4%为无效,总有效率为84.6%;单因素分析显示,年龄、术前血小板计数及术后1周内血小板计数峰值对脾切除治疗ITP的预后有显著影响。Logistic回归分析示年龄是判断脾切除疗效的独立预后因素。通过构建的预后方程进行效能评价,显效组和非显效组的评分差异有统计学意义。结论:脾切除治疗ITP是一种安全有效的治疗方法,年龄是判断脾切除治疗ITP疗效的独立预后因素,本组构建的预后方程能较好地反映预后,对临床指导有一定价值。Objective：To assess the effect of splenectomy on the patients with idiopathic thrombocytopenic purpura（ITP）,to discuss the relevant factors related with the prognosis of splenectomy for ITP and to provide clinical reference.Method：Fifty-two cases of ITP patients who underwent splenectomy between 1999 and 2009 were retrospectively analyzed,and univariate analysis was made by using SPSS software.Variables reaching statistical significance（P0.05） were subsequently introduced in logistic regression to identify the independent predictive factors.Result：During follow-up periods（range 4～118 months）,67.3% of 52 cases had excellent responses,17.3% had effective response and 15.4% had no response.Total effective rate was 84.6%;The factors including age,preoperative platelet counts and the peak of postoperative platelet counts within the first week were significantly associated with the prognosis of splenectomy for ITP patients.Only age was obtained as independent predictive factor by logistic regression.A prediction equation built gave different scores between excellent group and non excellent group with statistical significance.Conclusion：Splenectomy is a safe and effective management,and age was an independent predictive factor for the ITP patients.The prediction equation is very effective in evaluating the prognosis of splenectomy for ITP and is valuable in guiding clinical treatment.

关 键 词：紫癜 血小板减少性 脾切除术 预后因素 

分 类 号：R554[医药卫生—血液循环系统疾病]