[HIV-associated thrombocytopenia].
[HIV-associated thrombocytopenia].
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发表时间：
1988-02
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通讯作者：
J. Jost;M. Täuber;Ruedi Lüthy;W. Siegenthaler
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作者：
J. Jost;M. Täuber;Ruedi Lüthy;W. Siegenthaler
血小板减少症是HIV（人类免疫缺陷病毒）感染的一种相对常见的血液学并发症。血小板减少症的发病率在一个队列的359同性恋或双性恋男性艾滋病毒感染者是3%，而它是9%的队列的321例艾滋病毒阳性的静脉吸毒史。我们对42例血小板减少症患者进行前瞻性随访，以研究血小板减少症在这些患者中的临床意义。静脉注射药物滥用者的血小板减少症明显比同性恋或双性恋男性更严重：52%的药物滥用者血小板计数低于10，000/mm 3，而同性恋或双性恋男性只有9%。出血症状，几乎总是无害的皮肤或粘膜出血，在45%的有静脉吸毒史的患者和18%的同性恋或双性恋男性中发现。在约1年的中位观察期内，未发生危及生命的出血事件。泼尼松是症状性血小板减少症最常用的药物，仅在给药时才有明显的效果。停药后，血小板计数通常降至治疗前水平。我们的研究结果表明，HIV相关性血小板减少症的治疗应保留给症状严重的患者，特别是因为这种HIV感染的症状很少引起严重的并发症，我们不知道药物如皮质类固醇对HIV感染的进展速度的影响。
Thrombocytopenia is a relatively frequent hematological complication of HIV (human immunodeficiency virus) infection. The incidence of thrombocytopenia in a cohort of 359 homo- or bisexual men with HIV infection was 3%, while it was 9% in a cohort of 321 HIV positive persons with a history of intravenous drug abuse. We followed 42 thrombocytopenic patients prospectively to study the clinical significance of thrombocytopenia in these patients. Thrombocytopenia was significantly more severe in intravenous drug abusers than in homo- or bisexual men: 52% of the drug abusers had thrombocyte counts below 10,000/mm3, compared with only 9% of the homo- or bisexual men. Symptoms of bleeding, almost always harmless skin or mucosal bleeding, were found in 45% of patients with a history of intravenous drug abuse and in 18% of the homo- or bisexual men. Life-threatening bleeding episodes did not occur during a median observation period of approximately one year. Prednisone was the most commonly used drug in symptomatic thrombocytopenia and had demonstrable effect only while being administered. After medication was stopped the thrombocyte counts usually fell to pretreatment values. Our findings suggest that therapy of HIV-associated thrombocytopenia should be reserved for severely symptomatic patients, particularly since this symptom of HIV infection rarely causes serious complications and we do not know the influence of drugs such as corticosteroids on the progression rate of HIV-infection.