Idiopathic thrombocytopenia, initial illness and long term follow up.
Idiopathic thrombocytopenia, initial illness and long term follow up.
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特发性血小板减少症、初始疾病和长期随访。
DOI：
10.1136/adc.59.4.316
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发表时间：
1984
影响因子：
5.2
通讯作者：
W. Walker
中科院分区：
文献类型：
--
作者：
R. Walker;W. Walker
对一百八十一名患有无法找到原因的血小板减少症的儿童进行了研究。一名患者因严重出血死亡，可能是由于弥散性血管内凝血，一名患者出现脑出血，均在发病后两周内发生。 135 名急性病患者中，91% 的患者自行缓解，但只有 36% 的慢性病患者自行缓解。百分之二十的自发缓解发生在发病一年多后。 6 名患者已间歇性病程 10 至 20 年。 4 名患者患有无症状血小板减少症 10 至 30 年。在接受脾切除治疗的 32 名儿童中，有 24 名在此后维持了正常的血小板值。一名男孩在脾切除术后两年死于肺炎球菌败血症，但他没有接受预防性青霉素治疗。 158 名患者在发病后 3 至 37 年（平均 16.4 年）进行了随访。自发恢复或脾切除后恢复的患者均未出现进一步出血问题。没有患者或直系亲属患上其他自身免疫性疾病。我们认为，在所有病例中，诊断后立即使用短期皮质类固醇治疗都是合理的，尽管我们无法提供证据证明它会影响疾病的进程。我们不接受任何地方的长期免疫抑制剂治疗。
One hundred and eighty one children with thrombocytopenia for which no cause could be found have been studied. One patient died with severe bleeding possibly from disseminated intravascular coagulation and one developed cerebral haemorrhage, both within two weeks of onset. Ninety one per cent of the 135 with acute disease but only 36% of those with chronic disease remitted spontaneously. Twenty per cent of spontaneous remission occurred more than one year after onset. Six patients have run an intermittent course for 10 to 20 years. Four patients have had symptomless thrombocytopenia for between 10 and 30 years. Of 32 children treated by splenectomy 24 maintained normal platelet values thereafter. One boy died from pneumococcal septicaemia two years after splenectomy but he had not received prophylactic penicillin. One hundred and fifty eight patients were followed up 3 to 37 years (mean 16.4 years) after onset. None who recovered spontaneously or after splenectomy had had further bleeding problems. No patient nor immediate relative had developed other autoimmune disease. We consider that a short course of corticosteroids immediately after diagnosis is justified in all cases even though we cannot produce proof that it influences the course of the disease. We do not accept any place for long term immunosuppressant treatment.
免疫性血小板减少性紫癜患者中抗体与血小板相关抗原结合的证明。
影响因子：
20.3
作者：
McMillan,R;Tani,P;Mason,D
通讯作者：
Mason,D