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作者：Jung JH 等 翻译：刘佩玲 发布者：翟佳羽 审校者：李常虹
目的： 根据系统性红斑狼疮(SLE)患者的血小板减少程度及对治疗的反应情况来研究其临床特点及预后。
方法： 我们回顾性的评价了230例伴有血小板减少的狼疮患者，并分析了他们的临床数据及实验室结果。血小板减少的定义为血小板计数低于100,000/mm，根据血小板降低程度，将人群分为3组：轻度(血小板计数>50,000/mm)、中度(血小板计数>20,000/mm, ≤50,000/mm)和重度(血小板计数≤20,000/mm)。对各组人群的临床特点、治疗方法及预后进行对比。此外，治疗后血小板计数>100,000/mm称血小板减少症完全缓解。
结果： 研究发现，血小板减少症严重程度不同患病人群的临床特点及实验室结果无明显差异。然而重度血小板减少症患者更易并发出血风险(P<>，其死亡率更高(P=0.001)。85.2%患者可达到完全缓解。在达到或未达到完全缓解状态的患者中，临床特点及治疗方法无差异。完全缓解患者的死亡率(1.5%)显著低于未完全缓解患者的死亡率(29.4%，P?<>。完全缓解患者的生存率显著升高(OR=0.049，P<>。
结论： 狼疮患者血小板减少症严重程度可作为预测生存率的独立预后因子。此外，治疗后血小板减少的完全缓解情况也可作为重要预后因子。应严密监测血小板减少症的严重程度及对治疗反应，以评估狼疮患者的预后。
附原文： The aim of the study was to examine the clinical characteristics and prognosis according to severity of thrombocytopenia and response to treatment for thrombocytopenia in patients with systemic lupus erythematosus (SLE).We retrospectively evaluated 230 SLE patients with thrombocytopenia, and reviewed their clinical data and laboratory findings. Thrombocytopenia was defined as platelet counts under 100,000/mm, and patients were divided into 3 thrombocytopenia groups according to severity: mild (platelet counts >50,000/mm), moderate (), and severe (≤20,000/mm). Clinical characteristics, treatments, and prognoses were compared among the groups. Furthermore, complete remission of thrombocytopenia was defined as platelet counts >100,000/mm after treatment.There was no significant difference in clinical or laboratory findings among the groups according to severity of thrombocytopenia. However, hemorrhagic complications were more frequent in severe thrombocytopenia (P?
引自： Jung JH, Soh MS, Ahn YH.Thrombocytopenia in Systemic Lupus Erythematosus: Clinical Manifestations, Treatment, and Prognosis in 230 Patients.Medicine (Baltimore). 2016 Feb;95(6).
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