Analysis of clinical characteristics and prognostic influencing factors of patients with thrombotic thrombocytopenic purpura
10.3760/cma.j.cn115356-20231020-00059
- VernacularTitle:血栓性血小板减少性紫癜患者临床特征及预后影响因素分析
- Author:
Lan CHEN
1
;
Yeqiong LI
;
Xiupeng YE
Author Information
1. 宁夏医科大学附属第三临床医学院（宁夏回族自治区人民医院），银川 750002
- Keywords:
Purpura, thrombotic thrombocytopenic;
Clinical characteristics;
Laboratory indexes;
Prognosis
- From:
Journal of Leukemia & Lymphoma
2024;33(7):411-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics and prognostic influencing factors of patients with thrombotic thrombocytopenic purpura (TTP).Methods:A retrospective case series study was conducted. The clinical data of 15 TTP patients who were admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2013 to December 2022 were retrospectively analyzed, and the clinical manifestations, changes in laboratory indexes and prognostic influencing factors of patients were analyzed.Results:The 15 TTP patients were aged (61±4) years old, including 8 males and 7 females. The involvement of neurological, renal, gastrointestinal, hematologic, circulatory, respiratory, and rheumatologic-immune systems was found in 15, 12, 12, 11, 8, 7, and 3 cases, respectively, with 9 cases of fever and 5 cases of bleeding. Decreased platelet count (Plt) and hemoglobin were most commonly present, with 15 and 14 cases, respectively, followed by elevated lactate dehydrogenase (LDH) and D-dimer, and the presence of fragmented erythrocytes, all in 13 cases, and then elevated total bilirubin (12 cases), elevated indirect bilirubin (12 cases), decreased mean corpuscular volume (MCV) (11 cases), significantly decreased ADAMTS13 activity (8 cases), elevated troponin T (8 cases) and elevated reticulocyte count (Ret) (5 cases) were also commonly detected. Total bilirubin, indirect bilirubin, D-dimer, LDH and creatinine in the poor prognosis group (8 cases) were higher than those in the good prognosis group (7 cases) (all P < 0.05), and Plt was lower than that in the good prognosis group ( P = 0.014). Conclusions:The clinical manifestations of TTP are diverse and can involve multiple systems. Decreased Plt, hemoglobin, MCV and ADAMTS13 activity, and elevated LDH, D-dimer, total bilirubin, indirect bilirubin, troponin T and Ret, and the presence of fragmented erythrocytes contribute to the diagnosis of TTP. Decreased Plt and elevated total bilirubin, indirect bilirubin, LDH, D-dimer and creatinine may be poor prognostic factors for TTP patients.
