NEJM教你Immune Thrombocytopenia (ITP)所需要知道的一切

原创:阿尔法君阿尔法医学英语1周前

NEJM教你ImmuneThrombocytopenia,ITP所需要知道的一切

Immune Thrombocytopenia (ITP) 是临床常见的疾病。NEJM 刚刚发表的这篇文章,可以帮你了解ITP的最新进展。

让我先来认识这个单词吧:

thrombocytopenia

包括三个词根:thrombo-, cyto-, penia –

thrombo –血小板 ,血栓的词根。认识这个单词,那么其他单词应该也会熟悉了:thrombocytosis (血小板增多症),thrombosis (血栓)。为什么血小板和血栓是同一个词根呢?因为很多血栓的形成是由于血小板聚集

cyto- 是细胞的意思。上面提到的thrombocytosis (血小板增多症)也包括了这个词根。Cytopenia就表示细胞减少,扩展词汇:

bicytopenia两系血细胞减少 (比如贫血和血小板减少)

pancytopenia全系血细胞减少

penia 是减少的意思。上面的单词提到了这个词根。另外常见的,也是临床上的急症:neutropenia (白细胞减少)

ITP的发病机制:

NEJM教你ImmuneThrombocytopenia,ITP所需要知道的一切

ITP如何诊断?

Immune thrombocytopenia (ITP) is defined asa platelet count below 100,000 per cubic millimeterin patients in whom other causes of thrombocytopenia have been ruled out.

下面的临床问题,你都能回答吗:

· 所有的ITP病人都需要治疗吗?

·什么时候开始治疗?

·一线用药是什么?

· ITP病人血小板很低,但没有严重出血,需要输注血小板补充吗?

·脾切除还用于治疗ITP吗?

看完NEJM的这篇文章就能明白。

本文的KEY CLINICAL POINTS

Immune Thrombocytopenia

·Immune thrombocytopenia (ITP) is diagnosed in patients witha platelet count below 100,000 per cubic millimeterin whom other causes of thrombocytopenia have been ruled out.

·Patients with ITP who presentwith serious bleedingtypically receive platelet transfusions, glucocorticoids, and intravenous immune globulin.

·In patientswith no bleeding or nonserious bleeding,treatment decisions are guidedby the patient’s platelet count, age, coexisting conditions, and preference.

·Glucocorticoidsare used as first-line treatment, but prolonged use should be avoided owing to adverse effects.

·For patients in whomITP does not remit or relapses soon after glucocorticoid treatment, other medications for which there are high-quality data includethrombopoietin-receptor agonists and rituximab.

· Splenectomy is not recommended during the first yearafter diagnosis of ITPunless medical treatment is not available; otherwise, it is reserved for patients with ITP that is refractory to medical treatment.

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音频:

nejmcp1810479.mp3来自阿尔法医学英语00:0025:16

AlphaMedEnglish

作者:阿尔法君

编辑:西瓜籽

审核:ZincJ