中国实用儿科杂志

中国实用儿科杂志

• 指南解读 •    下一篇

《2019年美国血液学会免疫性血小板减少症指南》儿童部分解读

  

  1.  华中科技大学同济医学院附属同济医院儿童血液科，湖北  武汉  430030
  • 出版日期:2021-02-06 发布日期:2021-03-19

Interpretation of American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia（the part for children）

  1. Department of Pediatric Hematology，Tongji Hospital Affiliated to Tongji Medical College of HUST， Wuhan  430030，China
  • Online:2021-02-06 Published:2021-03-19

摘要： 免疫性血小板减少症（immune thrombocytopenia，ITP）是一种获得性自身免疫性疾病，其主要机制为血小板破坏过多及生成受阻导致血小板计数减少。一般人群中ITP的发病率为2/10万～5/10万。新版指南提供了儿童ITP一线和二线治疗方案，一线治疗方案包括观察、门诊、皮质类固醇、抗D免疫球蛋白、静脉注射免疫球蛋白（intravenous immunoglobulin，IVIG），二线治疗方案包括利妥昔单抗、血小板生成素受体激动剂（thrombopoietin receptor agonists，TPO-RA）、脾切除术。另有一些三线药物治疗但指南未给出明确建议。

关键词: 美国血液学会, 儿童, 免疫性血小板减少症, 指南

Abstract: Immune thrombocytopenia（ITP） is an acquired autoimmune disorder characterized by a low platelet count resulting from platelet destruction and impaired platelet production. The incidence of ITP is estimated to be 2 to 5 per 100 000 persons in the general population. The latest guidelines offer first-and second-line treatments for ITP in children. The first-line treatment options include observation，outpatient visit，corticosteroids，anti-D immunoglobulin and intravenous injection of immunoglobulin（IVIG）. The second-line treatments include rituximab，thrombopoietin receptor agonists（TPO-RA） and splenectomy. There are other third-line treatments，for which the guidelines do not make clear recommendations.

Key words: American Society of Hematology, child, immune thrombocytopenia, guideline