血栓性微血管病9例临床分析

Clinical analysis of nine patients with thrombotic microangiopathy

关键词:  血栓性微血管病  临床分析  发病机制

Key words:  thrombotic microangiopathy  clinical analysis  pathogenesis

摘要:

［目的］了解血栓性微血管病（Thrombotic microangiopathy，TMA）的临床特征及治疗，结合文献探讨其发病机制以加深对该病的认识。［方法］对9例TMA患者的临床表现特点、治疗及预后进行回顾性分析。［结果］患者主要临床表现为微血管病性贫血（9/9），血小板减少（9/9），乳酸脱氢酶升高（9/9），不同程度的肾脏损害和中枢神经系统症状（9/9），发热（5/9）；6例治愈，3例死亡。［结论］TMA起病急、进展快、死亡率高、预后差，应提高对本病的认识，早诊断、早治疗、减少死亡率。

Abstract:

［Objective］To study the clinical characteristics and treatment of thrombotic microangiopathy (TMA) for improve recognition of TMA,combined with reviewing literatures.［Methods］Clinical data including manifestation,treatment and prognoses of 9 patients with TMA admitted to our hospital between January 2007 and December 2010 were analyzed retrospectively.［Results］The clinical manifestation was characterized by microangiopathic hemolytic anemia (9/9),thrombocytopenia (9/9),elevated serum LDH value (9/9),renal damage and neurological abnormalitics (9/9) and fever (5/9).Six of the patients were cured and 3 of them died.［Conclusion］TMA is a kind of severe acute syndrome with high mortality and bad prognosis.We should improve recognition of TMA for quick diagnosis and treatment in order to obtain better efficacy and less mortality.