血浆置换联合利妥昔单抗抢救难治性血栓性血小板减少性紫癜1例

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1、授予单位代码10089学号或申请号20153340中国图书分类号R733.3HebeiMedicalUniversity硕士学位论文专业学位血浆置换联合利妥昔单抗抢救难治性血栓性血小板减少性紫癜1例研究生：彭程导师：孟建波教授孙丽霞副教授专业：内科学二级学院：第三医院2018年3月目录中文摘要……………………………………………………….....1英文摘要……………………………………………………….....2英文缩写……………………………………………………….....3研究论文血浆置换联合利妥昔单抗抢救难治性血栓性血小板减少性紫

2、癜1例前言…………………………………………………….….….4病例简介……………………………………………….….......4讨论…………………………………………………………...7结论…………………………………………………………...9参考文献……………………………………………………...11综述简述血栓性血小板减少性紫癜及有关研究新进展.…………….13致谢.…………………………………………….……….………..18个人简历…………………………………………………………..19中文摘要血浆置换联合利妥昔单抗抢救难治性血栓性血

3、小板减少性紫癜1例摘要目的：探讨难治性血栓性血小板减少性紫癜的临床特点及其诊断与治疗手段。方法：分析1例血浆置换联合利妥昔单抗成功治疗难治性血栓性血小板减少性紫癜患者的病例特点及诊疗过程。结果：患者出现血小板减少、微血管病性溶血性贫血和神经精神症状，完善相关化验检查，且经先期血浆置换后患者未见明显缓解，证实为难治性血栓性血小板减少性紫癜，继续给予血浆置换并加用利妥昔单抗治疗，后患者病情好转，治疗成功。结论：难治性血栓性血小板减少性紫癜临床症状复杂，预后不良，应早期诊断，积极治疗，血浆置换仍是目前我国血栓性血小板减少性紫癜的一线

4、治疗方法，利妥昔单抗在治疗过程中亦起到重要作用。关键词：难治性血栓性血小板减少性紫癜，血管性血友病因子裂解蛋白酶，感染，预后不良，血浆置换，利妥昔单抗1英文摘要Refractorythromboticthrombocytopenicpurpurabetreatedsuccessfullybyplasmaexchangeandrituximab:acasereportandliteraturereviewABSTRACTObjective:Todiscusstheclinicalcharacteristics,diagnosis

5、,andtreatmentofThromboticThrombocytopenicPurpura.Methods:Theclinicalcharacteristicsandsuccessfulplasmapheresisandrituximabtreatmentofapatientwithrefractorythromboticthrombocytopenicpurpurawereanalyzed.Results:Onthebasisofrelatedlaboratoryinspection,furthermorebythee

6、arlyplasmaexchangewithoutsignificantrelief,thepatientwiththrombocytopenia、Microangiopathichemolyticanemiaandneurologicaldeficitsbeconfirmedasrefractorythromboticthrombocytopenicpurpura.Wecontinuetoofferhimplasmaexchangeandrituximab,andwegetsuccessfultreatmentatlast.

7、Conclusions:Theclinicalcharacteristicsofrefractorythromboticthrombocytopenicpurpurawerecomplex,resultinginapoorprognosisandinacriticalconditionwithriskofinfection.Therefore,theneedforearlydiagnosisandtreatment.Theplasmaexchangeisstillthefirst-linetherapyforTTPinourc

8、ountryatpresent.Andrituximabalsoplaysanimportantrole.Keywords:Refractorythromboticthrombocytopenicpurpura,ADAMTS13,Infection,Poorprognosis