Objective: To probe the incidence and risk factors for thrombosis in Chinese immune thrombocytopenia through a retrospective analysis of the inpatients referred to the Blood Disease Hospital, CAMS & PUMC. Methods: A retrospective survey of 3 225 patients with ITP from October 2005 to December 2017 was performed, the clinical data of the patients with thrombosis were collected to analyze the causes, diagnosis, treatment and prognosis. Results: A total of 46 patients experienced a thrombotic event with a prevalence of 1.43%(46/3 225 cases) with the median age of thrombosis as 54 years (26-83) years, the prevalence of thrombosis was 3.37% (40/1 187 cases) in>40 years old, which was significantly higher than 0.58% (6/1 030 cases) in those under 40 years old, in adults (P=0.00). There were 20 males and 26 females, there was no statistical difference in the incidence of thrombosis between males and females[1.53% (20/1 309) vs 1.36% (26/1 916), P=0.187]; The prevalence of arterial thrombosis was 1.12% (36/3 225) higher than venous thrombosis[0.22% (7/3 225), P=0.00]when 82.61%(38/46 cases) of patients with PLT<100×10(9)/L. Post-splenectomy are risk factors for thrombosis in ITP patients, P values was 0.022, There was no statistical difference in the presence or absence of thrombotic events whether received glucocorticoid or TPO/TPO-Ra treatment, the P values were 0.075 and 0.531, respectively. Conclusions: In Chinese population, ITP disease maybe with a higher risk of thrombosis, there was no positive correlation between thrombosis and platelet level; and had obvious age distribution characteristics. The history of tobacco, hypertension, diabetes and post-splenectomy are risk factors for thrombosis in ITP patients.
目的: 探讨原发免疫性血小板减少症(ITP)患者血栓发生情况及相关危险因素。 方法: 对2005年12月至2017年12月在中国医学科学院血液病医院血栓止血中心住院治疗的3 225例ITP患者进行回顾性分析。 结果: 共46例患者(1.43%)发生血栓事件,中位发病年龄为54(26~83)岁,成人患者中>40岁人群血栓发生率明显高于40岁以下人群[3.37%(40/1 187)对0.58%(6/1 030),P=0.000]。男、女性患者血栓发生率差异无统计学意义[1.53%(20/1309)对1.36%(26/1 916),P=0.187]。动脉血栓的发生率高于静脉血栓[1.12%(36/3 225)对0.22%(7/3 225),P=0.000]。82.61%(38/46例)患者发生血栓时PLT<100×10(9)/L。吸烟、高血压病、糖尿病及脾切除是ITP患者发生血栓的危险因素(P值分别为0.232、0.531);糖皮质激素、TPO治疗患者治疗在有无血栓事件的两组间比较差异无统计学意义(P值分别为0.064、0.075、0.531)。 结论: 对于中国人群,ITP疾病本身可能也是一种可伴发血栓的免疫性疾病,即使血小板水平低下仍可发生血栓事件;且具有明显的年龄分布特点;吸烟史、高血压病、糖尿病史及脾切除是发生血栓的危险因素。.
Keywords: Primary immune thrombocytopenia; Therapy; Thrombosis.