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| Clinical analysis of patients with thrombotic thrombocytopenic purpura |
| Shi Mao-jing, Huang Wen-feng, Gao Wei-bo, Zhu Ji-hong |
| Peking University People′s Hospital， Beijing 100044, China |
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Abstract Objective To investigate the clinical features, diagnosis, treatment and prognosis of thrombotic thrombocytopenic purpura (TTP). Methods The clinical data of 59 patients with TTP admitted to Peking University People′s Hospital from January 2004 to October 2018 were retrospectively analyzed. Results Among 59 patients with TTP, 21 were males and 38 were females, with an average age of （46.8±16.2） years. Fifty-five patients had the triad syndrome and 46 patients had the quinary syndrome. The average counts of platelet, hemoglobin, the percentage of erythrocyte fragments and free hemoglobin were (13.2±12.0)×109/L,(66.8±20.7) g/L, (4.6±4.1)% and (426.2±298.2) mg/L, respectively. The value or the activity of ADAMTS 13 decreased significantly. Fifty-nine patients were treated with glucocorticoid. Of 41 cases with plasma exchange, 28 cases survived, but of 18 cases without plasma exchange, 6 cases survived, there was a significant difference between the two groups (P<0.05). Six patients were treated with rituximab and four survived. Conclusion If TTP patients cannot be treated as soon as possible, the mortality is high, and plasma exchange can significantly improve the survival rate. Rituximab can be used as early as possible in patients with refractory TTP.
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