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作者用免疫抑制剂唑硫嘌呤(Azathioprine)治疗3例难治的自身免疫性血小板减少性紫癜(ITP)及2例全身性红斑狼疮(SLE)患者。治疗前作直接血小板Coombs试验、抗球蛋白消耗试验、抗核抗体(ANA)及血小板因子3“免疫损伤试验”检查,除1例ITP病人ANA阳性外,其他ITP病人均阴性。2例SLE病人有红斑狼疮细胞(LE)现象,特异性LE-凝集素试验及ANA均阳性,血清球蛋白比例增高,血小板6～9万/立方毫米。 3例ITP患者为控制严重的病情,初期用大剂量强的松龙治疗,以后减量维持6个月仍不缓解,又作脾摘除术,术后血小板数迅速上升,但3个月后又下降,重新出现严重出血。改用唑硫嘌呤治疗后3例病人均获明显进步,无出血表现,血小板数稳定,1例ANA试验仍阳性。
The authors used immunosuppressant Azathioprine to treat 3 refractory autoimmune thrombocytopenic purpura (ITP) and 2 patients with systemic lupus erythematosus (SLE). Before treatment, direct platelet Coombs test, anti-globulin consumption test, antinuclear antibody (ANA) and platelet factor 3 “immuno-damage test” examination, except one case of ITP patients with ANA positive, the other ITP patients were negative. 2 cases of SLE patients with lupus erythematosus cells (LE) phenomenon, specific LE-Lectin test and ANA were positive, elevated serum globulin, platelets 6 to 90,000 / cubic millimeter. 3 cases of ITP patients to control the severity of the disease, the initial high-dose prednisolone treatment, after 6 months of reduced volume remained unchanged, but also for splenectomy, the number of postoperative platelets increased rapidly, but 3 months later Decline, re-emergence of severe bleeding. Three patients after conversion to azathioprine were significantly improved, no bleeding, stable platelet count, and 1 case of ANA test was still positive.