Management and outcomes for patients with TTP: analysis of 100 cases at a single institution
Management and outcomes for patients with TTP: analysis of 100 cases at a single institution
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DOI：
10.1002/ajh.23455
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发表时间：
2013-07-01
影响因子：
12.8
通讯作者：
McCrae, Keith R.
中科院分区：
文献类型：
--
作者：
Chaturvedi, Shruti;Carcioppolo, Desiree;McCrae, Keith R.
血浆置换的出现显著提高了血栓性血小板减减性紫癜（TTP）患者的生存率，尽管仍有大约10%的患者死亡，三分之一的患者复发。鉴别低风险患者的临床特征尚未明确。我们回顾了2000年至2012年间在克利夫兰诊所接受首次TTP治疗的100例患者，以确定预测不良预后的因素。在多因素分析中，年龄增加，特别是60岁以下（RR: 7.08, 95% CI: 2.15-23.39， P=0.002），出现时严重的神经系统症状（RR: 18.37, 95% CI: 4.19-80.13, P5%）是不良肾脏结局（需要透析和进展为慢性肾脏疾病）的独立预测因子。这些变量可能有助于风险分层和识别可能从早期辅助治疗中获益的患者。点。中华血液学杂志，2013,33(4):559 - 564。(c) 2013 Wiley Periodicals, Inc.；
The advent of plasma exchange has led to a dramatic improvement in the survival of patients with thrombotic thrombocytopenic purpura (TTP), though approximately 10% of patients still die and a third suffer relapses. Clinical features that identify poor risk patients have not been clearly identified. We reviewed 100 patients who were treated for a first episode of TTP at the Cleveland Clinic between 2000 and 2012 to identify factors predictive of poor outcomes. On multivariate analysis, increasing age, especially age>60 (RR: 7.08, 95% CI: 2.15-23.39, P=0.002), severe neurological symptoms at presentation (RR: 18.37, 95% CI: I4.19-80.13, P5% was an independent predictor of adverse renal outcomes (need for dialysis and progression to chronic kidney disease). These variables may be useful for risk stratification and identification of patients who could potentially benefit from early institution of adjunctive therapy. Am. J. Hematol. 88:560-565, 2013. (c) 2013 Wiley Periodicals, Inc.