切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2019, Vol. 08 ›› Issue (02) : 72 -75. doi: 10.3877/cma.j.issn.2095-3259.2019.02.003

所属专题: 文献

专家论坛

妊娠合并重度特发性血小板减少性紫癜的诊治
黎静1, 钟梅1,()   
  1. 1. 510515 广州,南方医科大学南方医院妇产科
  • 收稿日期:2019-02-11 出版日期:2019-05-18
  • 通信作者: 钟梅

Diagnosis and treatment of pregnancy complicated with severe idiopathic thrombocytopenic purpura

Jing Li1, Mei Zhong1()   

  • Received:2019-02-11 Published:2019-05-18
  • Corresponding author: Mei Zhong
引用本文:

黎静, 钟梅. 妊娠合并重度特发性血小板减少性紫癜的诊治[J]. 中华产科急救电子杂志, 2019, 08(02): 72-75.

Jing Li, Mei Zhong. Diagnosis and treatment of pregnancy complicated with severe idiopathic thrombocytopenic purpura[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2019, 08(02): 72-75.

妊娠合并特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)是孕妇妊娠期间常见的血液系统疾病,临床表现以出血为主,贫血及感染风险轻度增加,ITP在整体上并不影响母儿结局,但会使出血的风险增加。本文重点就妊娠合并重度ITP的诊治、对母儿影响及孕期管理进行讨论。

Idiopathic thrombocytopenic purpura (ITP) is a common blood system disease during pregnancy. Hemorrhage is the main clinical manifestation, and the risk of anemia and infection is slightly increased. ITP does not affect the outcome of mother and child as a whole, but it will increase the risk of bleeding. This article focuses on the diagnosis and treatment of pregnancy with severe ITP, the impact on mother and child and the management of pregnancy.

[1]
Stasi R,Newland AC.ITP:a historical perspective[J].Br J Hematol, 2011, 153(4): 437-450.
[2]
Lee JY, Lee JH, Lee H, et al. Epidemiology and management of primary immune thrombocytopenia: A nationwide population-based study in Korea [J]. Thromb Res, 2017, 155: 86-91.
[3]
Nazarpour S, Ramezani TF, Simbar M, et al. Effects of levothyroxine treatment on pregnancy outcomes in pregnant women with autoimmune thyroid disease[J]. Eur J Endocrinol, 2017, 176(2): 253-265.
[4]
Calderwood CJ, Greer IA. The role of factor V Leiden in maternal health and the outcome of pregnancy [J]. Current drug targets, 2005, 6(5): 567-576.
[5]
Frederiksen H,Schmidt K.The incidence of idiopathic thrombocytopenicpurpura in adults increases with age [J]. Blood, 1999, 94(3): 909-913.
[6]
Rossio R, Lotta LA, Pontiggia S, et al.A novel CD46 mutation in a patient with microangiopathy clinically resembling thrombotic thrombocytopenic purpura and normal ADAMTS13 activity [J]. Haematologica, 2015, 100(3): e87-e89.
[7]
Ramakrishna R, Rehman A, Ramakrishna S, et al. Use of romiplostim in patients with chronic idiopathic thrombocytopenic purpura during perioperative period [J]. Intern Med J, 2015, 45(7): 718-724.
[8]
Karakurt N, Uslu I, Albayrak C, et al. Neonates born to mothers with immune thrombocytopenia: 11 years experience of a single academic center [J]. Blood Coagul Fibrinolysis, 2018, 29(6): 546-550.
[9]
Zdravic D, Yougbare I, Vadasz B, et al. Fetal and neonatal alloimmunethrombocytopenia [J]. Semin Fetal Neonatal Med, 2016, 21(1): 19-27.
[10]
Loustau V, Pourrat O, Mandelbrot L, et al. Immune thrombocytopenia and pregnancy: State of knowledge and unanswered questions[J]. Rev Med Interne, 2015, 36(3): 167-172.
[11]
Neunert C, Lim W, Crowther M, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia[J]. Blood, 2011, 117(16): 4190-4207.
[12]
McCrae KR.Thrombocytopenia in pregnancy:differential diagnosis, pathogenesis, and management [J]. Blood Rev, 2003, 17(1): 7-14.
[13]
vanVeen JJ, Nokes TJ, Makris M. The risk of spinal haematomafollowingneuraxialanaesthesiaor lumbar puncture in thrombocytopenic individuals [J]. Br J Haematol, 2010, 148(1): 15-25.
[14]
Tanaka H, Tenkumo C, Mori N, et al. Case of maternal and fetal deaths due to severe congenital thrombotic thrombocytopenic purpura(Upshaw-Schulman syndrome) during pregnancy [J]. J Obstet Gynaecol Res, 2014, 40(1): 247-249.
[15]
Rasmus KT, Rottman RL, Kotelko DM, et al. Unrecognized thrombocytopenia and regional anesthesia in parturients: are trospective review [J]. Obstet Gynecol, 1989, 73(6): 943-946.
[16]
Liu Y, Wang R, Han P, et al. Effect of recombinant human thrombopoietin on immune thrombocytopenia inpregnancy in a murine model [J]. Int Immunopharmacol, 2018, 17(67): 287-293.
[17]
Park-Wyllie L, Mazzotta P, Pastuszak A, et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies [J]. Teratology, 2000, 62(6): 385-392.
[18]
Nicolescu A, Vladareanu AM, Voican I, et al. Therapeutic Options for Immune Thrombocytopenia(ITP)During Pregnancy [J]. Maedica, 2013, 8(2): 182-188.
[19]
Hisano M, Tsukada N, Sago H, et al. Successful prevention of exacerbation of thrombocytopenia in a pregnant patient with idiopathic thrombocytopenic purpura by anticoagulation treatment [J]. BMC Pregnancy Childbirth, 2015, (15): 48-52.
[20]
Hachisuga K, Hidaka N, Fujita Y, et al. Can we predict neonatal thrombocytopenia in offspring of women with idiopathic thrombocytopenic purpura?[J]. Blood Research, 2014, 49(4): 259-264.
[21]
Subbaiah M, Kumar S, Roy KK, et al. Pregnancy outcome in patients with idiopathic thrombocytopenic purpura [J]. Archives of Gynecology andObstetrics, 2014, 289(2): 269-273.
[22]
Kong Z, Qin P,Xiao S, et al. A novel recombinant human thrombopoietin therapy for the management of immune thrombooytopenia in pregnancy [J]. Blood, 2017, 130(9): 1097-1103.
[23]
Wang S, Yang R, Zou P, et al. A muhicenter randomized controlled trial of recombinant human thrombopoietin treatment in patients with primary immune thrombocytopenia [J]. Int J Hematol, 2012, 96(2): 222-228.
[1] 薛静, 孙雅楠, 朱丽丽, 李淑红. 妊娠期急性脂肪肝孕产妇诊疗及其妊娠结局[J]. 中华妇幼临床医学杂志(电子版), 2024, 20(03): 312-321.
[2] 李倩, 刘倩, 朱海玲, 倪娟, 任宝芹, 刘长云. 重组人生长激素治疗特发性矮小症患儿的疗效[J]. 中华妇幼临床医学杂志(电子版), 2024, 20(03): 346-352.
[3] 李楠, 邱思齐, 薛鸣宇, 张英. 自伤性口腔损害及其疾病管理[J]. 中华口腔医学研究杂志(电子版), 2024, 18(05): 307-311.
[4] 罗霞, 王宝梅, 李淑景, 杨英. 特发性肺动脉高压血清PCSK9表达及预后意义[J]. 中华肺部疾病杂志(电子版), 2024, 17(04): 585-589.
[5] 周璇, 谢莉, 邹娟. 尼达尼布对特发性肺纤维化肺功能、肺纤维化程度及PDGF、PGE2、TGF-β1的影响[J]. 中华肺部疾病杂志(电子版), 2024, 17(03): 368-372.
[6] 吴沛玲, 娄月妍, 张洪艳, 陈东方, 刘雪青, 赵丽芳, 薛姗, 蒋捍东. 线粒体相关基因在特发性肺纤维化中的分析[J]. 中华肺部疾病杂志(电子版), 2024, 17(02): 178-184.
[7] 邱凌霄, 王创业, 卿斌, 刘锦程, 张鑫烨, 武文娟, 邢德冰, 郭亮, 徐智, 王斌. 基于转录组学筛选特发性肺纤维化的枢纽基因和信号通路[J]. 中华肺部疾病杂志(电子版), 2024, 17(02): 212-217.
[8] 徐嘉愉, 张复华, 牛国敏, 梁家宝, 潘焕玉, 麦秀蕖, 杨国雷, 徐嘉良, 黄佑勇. Th1/Th2细胞因子谱在恶性血液肿瘤患者化疗后中性粒细胞缺乏伴感染的应用价值[J]. 中华细胞与干细胞杂志(电子版), 2024, 14(03): 143-150.
[9] 张一健, 赵龙, 杨扬, 张贝贝, 张译予, 张斌. 造血干/祖细胞体外扩增和临床应用[J]. 中华细胞与干细胞杂志(电子版), 2024, 14(02): 122-127.
[10] 马丽洁, 赵素梅, 孙芳, 孙倩美. 平均血小板体积和平均血小板体积/血小板计数比值对血液透析患者血管通路失功的潜在预测价值[J]. 中华肾病研究电子杂志, 2024, 13(02): 61-67.
[11] 刘宇立, 姚瑶, 徐锦雯. 过敏性紫癜性肾炎患儿肾功能不全的影响因素分析[J]. 中华肾病研究电子杂志, 2024, 13(02): 68-73.
[12] 唐全兴, 周畅. 维持性血液透析患者血清suPAR对动静脉内瘘狭窄发生的诊断价值[J]. 中华肾病研究电子杂志, 2024, 13(02): 74-78.
[13] 柯彩萍, 林丽萍, 王晓怡, 李虹晔, 陈敦金. 关于双绒毛膜双羊膜囊双胎妊娠第二胎儿延迟分娩的临床研究[J]. 中华产科急救电子杂志, 2024, 13(03): 159-167.
[14] 张舒沁, 赵扬玉. 体外受精-胚胎移植与妊娠期高血压疾病[J]. 中华产科急救电子杂志, 2024, 13(02): 79-83.
[15] 陈念, 张连阳. 严重创伤救治中全血输注进展[J]. 中华诊断学电子杂志, 2024, 12(03): 145-148.
阅读次数
全文


摘要