A Retrospective Analysis Of Clinical Characteristics And Therapeutic Effect Of Elderly Idiopathic Thrombocytopenic Purura (ITP)

[Objectives]1.To describe the clinical characteristics of elderly idiopathic thrombocytopenic purura(ITP).2.To analyze the therapeutic response of elderly idiopathic thrombocytopenic purura(ITP).3.To evaluate clinical impact of platelet membrane glycoprotein (GP)-specific autoantibodies on glucocorticoids treatment in patients with elderly idiopathic thrombocytopenic purpura (ITP).[Methods]1.We retrospectively reviewed a cohort of 80 consecutive elderly ITP patients(>=60 years old), in the period between January 2000 and June 2009, who were consecutively diagnosed with ITP at the QILU Hospital. We specifically analyzed age, sex, initial presentation, clinical complication, counts of platelet befor therapies and after therapies, methods of therapies, patient response rates and adverse reaction.2.And analysis clinical impact of platelet membrane glycoprotein (GP)-specific autoantibodies on glucocorticoids treatment in patients with elderly idiopathic thrombocytopenic purpura (ITP) by principle of statistics. [Results]1. The age range of 80 patients was 60 to 86 years old and the median age was 65 years; the ratio of males to females was 0.9:1.2. Their initial presentation included bleeding limited to the skin or mucous (n=59,73.75%) and bleeding at organs or deep sites(n=11,13.75%),10 patients (12.5%) were asymptomatic.3.64 in 80 have the clinical complication, including hypertension, coronary artery disease, diabetes mellitus(DM) and alimentary tract hemorrhage.4.The near response rate was:70%(23/33) with corticosteroids,80%(20/25) with high-Dose dexamethasone,77%(10/13) with IVIG and 33%(3/9) with Recombinant Human Thrombopoietin (rhTPO) and the tolerance of these therapies was well.5.The response rate of corticosteroids in GPⅡb/Ⅲa and/or GPIb specific autoantibody-negative patients was significantly different from that of antibody-positive patients (p＜0.01); The response rate of GP Ib specific autoantibody-positive patients was lower than that of antibody-negative patients (p＜0.05), GPⅡb/Ⅲa specific autoantibody had no significant impact on the efficacy of corticosteroids (p＞0.05).[Conclusions]1.Most of eldly ITP patients genetally present as a chronic disease and had severe hemorrhage.2.Most of eldly ITP patients genetally fine response and tolerance to corticosteroids therapy.3.The response rate of GP Ib specific autoantibody-positive patients was poor.;GPⅡb/Ⅲa specific autoantibody had no significant impact on the efficacy of corticosteroids...