关键词: 特发性血小板减少性紫癜；脾切除术；预后分析

Abstract:

Objective      To investigate the efficacy of splenectomy on patients with idiopathic thrombocytopenic purpura(ITP), and the influence of the preoperative clinical indexes on the efficacy．Methods     Clinical data from 75 (11 men, 64 women) ITP patients with splenectomy were reviewed, and grouped according to the sex, age, course of disease, platelet count, megalokaryocyte number, spleen size, and treatment outcome of glucocorticoid. The relations of each factor with splenectomy efficacy were compared and analyzed.  Results     Among 75 cases, 42 with excellent response (56.0%), 18 with good response (24.0%), 9 with progression(12.0%),6 with no response(8%). 8 patients relapsed after surgery. The response rate (the percentage of cases with excellent and good response in all cases) was 80.0%. The response rates were 81.8% and 79.7% in male and female (P>0.05), 80.3% and 77.8％ in patients with and without spleen enlargement (P>0.05), 85.4% and 70.4% in patients younger and older than 40 years(P<0.05), 85.2 % and 66.7% in patients responsive and irresponsive to glucocorticoid therapy (P<0.05), 85.7% and 63.2% in patients with the bone marrow megakaryocyte number ≥ and < 7-35/(3×1.5)cm2 (P<0.05), 86.0%and 68.0% in patients with preoperative platelet count > and <20×109/L (P<0.05), and 84.5% and 64.7% in the disease course below and over 6 months, respectively (P<0.05). Conclusion     There is no relation of splenectomy efficacy with the gender or spleen size. However, the age, course of disease, bone marrow megakaryocyte number, platelet count, and the response to glucocorticoid are obviously relative to the efficacy of splenectomy.

Key words: Idiopathic thrombocytopenic purpura；Splenectomy；Prognosis analysis