Idiopathic thrombocytopenic purpura (ITP) By Mayo Clinic staff

nqwang

这篇文章被CNN引用，希望对大家有所帮助。

原文链接：http://www.mayoclinic.com/health ... S00844/METHOD=print

Definition

Idiopathic thrombocytopenic purpura (ITP), also called immune thrombocytopenic purpura, is a blood-clotting disorder that can lead to easy or excessive bruising and bleeding. ITP results from unusually low levels of platelets — the cells that help your blood clot.

Idiopathic thrombocytopenic purpura affects both children and adults. Children often develop idiopathic thrombocytopenic purpura after a viral infection and usually recover fully without treatment. In adults, however, the disorder is often chronic.

Treatment of idiopathic thrombocytopenic purpura depends on your symptoms and platelet count. If you don't have signs of bleeding and your platelet count isn't too low, treatment for idiopathic thrombocytopenic purpura usually isn't necessary. More serious cases may be treated with medications or, in critical situations, with surgery.

定义

血小板介绍性紫癜（ITP），又称免疫性血小板减少性紫癜，是一种凝血紊乱，可以引起出血倾向或者过度瘀伤。ITP的结果是血小板个数异常低 - 血小板，帮助您的止血功能。

儿童和成人都会得血小板减少性紫癜，儿童通常因为病毒感染而引起血小板减少性紫癜，并且可以在不使用药物的情况下，完全自愈。而成人，往往会转化成一种慢性病。

血小板介绍性紫癜的治疗是依据个人的症状和血小板计数。如果没有出血征兆或倾向，并且血小板计数不是很低，血小板减少性紫癜通常不要治疗，而在严重的情况下，可以用药物或在危急情况下，进行手术治疗。

nqwang

Symptoms

Idiopathic thrombocytopenic purpura (ITP) may have no symptoms. When signs and symptoms do occur, they may include:

• Easy or excessive bruising (purpura) — your skin naturally bruises and bleeds more easily as you age, but this shouldn't be confused with ITP
• Superficial bleeding into your skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on your lower legs
• Prolonged bleeding from cuts
• Spontaneous bleeding from your gums or nose
• Blood in urine or stools
• Unusually heavy menstrual flows
• Profuse bleeding during surgery
  

症状

• 血小板介绍性紫癜（ITP）可能没有任何症状。也可能出现以下症状：
• 容易出现或者过度出现瘀伤（紫癜）
• 皮肤浅表性出血，你的皮肤出现如针尖大小的红紫色斑点，通常出现在小腿
• 止血时间加长
• 出现血尿，便血
• 月经量加大
• 手术中出现大出血
  

nqwang

When to see a doctor

If you or your child has abnormal bleeding or bruising, or develops a rash of pinpoint-sized red spots, see your doctor. It's also important to seek medical advice if you're a woman and suddenly develop significantly increased menstrual bleeding, as this may be a sign of ITP.

Serious or widespread bleeding indicates an emergency and requires immediate care.

什么时候看医生

如果你或你的孩子出现不正常的出血，瘀斑，或者针尖大小的红色斑点皮疹，你或者你的孩子就应该去医院检查。如果你是一个女人，突然月经出血量显著增加了，那么这可能是ITP的迹象，这也是重要的。

严重或广泛出血，则表明情况紧急，需要立即就医。

猫薄荷

成人就一定会是慢性的吗？？

nqwang

猫薄荷 发表于 2012-4-26 12:02

                               
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成人就一定会是慢性的吗？？

不一定，谢谢提建议，那句已经翻译成“而成人，往往会转化成一种慢性病。”

猫薄荷

nqwang 发表于 2012-4-26 13:39

                               
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不一定，谢谢提建议，那句已经翻译成“而成人，往往会转化成一种慢性病。”

儿童大部分是急性的，成人大部分是慢性都有一定的几率吧

傻丫头

成人急性的也有，慢性的多！

孟桐妃

你好,你英语很好的话,以后多找点国外的资料翻译吧,大家很需要你这样的人才哦.
谢谢!

nqwang

Causes

The exact cause of ITP isn't known. That's why it's referred to as idiopathic, which means "of unknown cause." It is known, however, that in people with idiopathic thrombocytopenic purpura, the immune system malfunctions and begins attacking platelets as if they were foreign substances.

Antibodies produced by your immune system attach themselves to the platelets, marking the platelets for destruction. The spleen, which helps your body fight infection, recognizes the antibodies and removes the platelets from your system. The result of this case of mistaken identity is a lower number of circulating platelets than normal.

Ordinarily, you have anywhere from 150,000 to 450,000 platelets per microliter of circulating blood. Adults and children with ITP often have platelet counts below 20,000. As the number of platelets decreases, your risk of bleeding increases. The greatest risk is when your platelet count falls very low — below 10,000 platelets per microliter. At this point, internal bleeding may occur despite a lack of any injury.

In most children with ITP, the disorder follows a viral illness, such as the mumps or the flu. It may be that an infection sets off the immune system, triggering it to malfunction.

发病原因

ITP准确的起因目前还是未知的。这也就是为什么被称为特发性，意思就是原因未知。已知的是，在患有特发性血小板减少性紫癜的患者，免疫系统发生故障，并开始攻击血小板，就像他们是外来物质。

你的免疫系统产生带有抗体的血小板，意味着血小板需要消灭。脾是助于你的身体对抗感染的器官，当发现带有抗体的血小板时，脾会在自身系统中消灭。在这种错误认识的情况下，会出现血小板数量比正常循环少。

正常来讲，人体必须有15万到45万微升的血小板在血液循环中。成人和儿童ITP患者血小板计数往往低于20,000。由于血小板数量减少，增加了出血的风险。而最大的风险是当你的血小板计数下降非常低 - 低于10,000血小板每微升。这时体内就可能发生出血，即使没有任何伤害。

在大多数儿童ITP患者中，这种障碍由如下病毒性疾病引起，如腮腺炎或流感。这可能是感染影响免疫系统，引发这种疾病。

nqwang

Risk factors

ITP is a fairly common blood disorder and can occur in anyone at almost any age, but these factors increase your risk:

Your sex. Women are about twice as likely to develop ITP as men are.
Age. Once considered a young person's disease, ITP is actually far more common in people older than 60 than it is in younger adults.
Recent viral infection. Many children with ITP develop the disorder after a viral illness, such as mumps, measles or a respiratory infection. In most children, ITP clears on its own within two to eight weeks.

患病因素

ITP是一种相当常见的血液疾病，可发生在几乎任何年龄的人，但以下因素会增加风险：

性别。女性患病风险是男性的两倍
年龄。曾经ITP被认为是一个年轻的人的疾病，但实际上年龄在60岁以上的人会比年轻的成年人更为普遍。
最近的病毒感染。许多患有ITP的儿童是在一种病毒性的疾病后引起的，如腮腺炎，麻疹或呼吸道感染。但在大多数的孩子，ITP会在两至八个星期内自愈。

nqwang

Complications

The biggest risk associated with idiopathic thrombocytopenic purpura is bleeding, especially bleeding into the brain (intracranial hemorrhage), which can be fatal. Major bleeding is rare with ITP, however. Complications are more likely to arise from the treatments — corticosteroids and surgery — used for chronic or severe ITP. In fact, many therapies pose more serious potential risks than does the disease.

Long-term use of corticosteroids can cause serious side effects, including:

• Osteoporosis
• Cataracts
• Loss of muscle mass
• Increased risk of infection
• High blood sugar, even diabetes
  

Removal of your spleen (splenectomy), which may be performed if corticosteroids aren't working, also makes you permanently more vulnerable to infection, although the risk of an overwhelming infection in a healthy person who has had a splenectomy is low.

Pregnancy
Pregnant women with mild ITP usually have a normal pregnancy and delivery, though antibodies to platelets can cross the placenta and affect the baby's platelet count. In some cases, a baby may be born with a low number of platelets. If this happens, your baby's doctor will want to monitor your child for several days, because your baby's platelet count may drop before it starts to rise. It's likely that your baby's platelet count will improve without treatment, but if the count is very low, treatment can help speed recovery.

If you're pregnant and your platelet count is very low or you have bleeding, you have a greater risk of heavy bleeding during delivery. In such cases, you and your doctor may discuss treatment to maintain a stable platelet count, taking into account the effects on your baby.

并发症　　　　

ITP最大的风险是自身出血,尤其是颅内出血，那将是致命的。ITP引起出血很少见，主要是ITP引起的紫癜，但是。并发症更多是由于治疗中使用糖皮质激素或者手术引起的。事实上，许多治疗带来的潜在的风险要比疾病本身更严重。
　　　
长期应用糖皮质激素能引起严重的副反应,包括:

• 骨质疏松症
• 白内障
• 减轻肌肉质量
• 增加感染的风险
• 血糖升高,甚至发展成糖尿病
  

脾脏切除（脾切除），如果糖皮质激素没有效果可以考虑这个方案，但同时还能让自身永久性的使感染更容易，尽管患者感染传染病的风险要比一个脾脏切除术的风险要低。

怀孕
轻度ITP的孕妇通常可以正常的怀孕和分娩，虽然血小板的抗体可以通过胎盘影响宝宝的血小板计数。在某些情况下，婴儿出生时血小板数量低。如果发生这种情况，医生将需要数天来监视你的孩子，因为宝宝的血小板开始上升之前可能会下降。它很可能是宝宝的血小板计数将未经处理改善，但如果计数非常低，可以通过治疗帮助加速恢复。

如果你是孕妇并且血小板计数是非常低的，或有伴有出血，那么分娩过程中大量出血的风险会更大。在这种情况下，考虑到对宝宝的影响，你需要和你的医生讨论如何保持一个稳定的血小板计数的治疗方案。

笑笑

桐妃 发表于 2012-4-26 23:18

                               
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你好,你英语很好的话,以后多找点国外的资料翻译吧,大家很需要你这样的人才哦.
谢谢!

他也是算搞IT的，说有什么需要帮忙的尽管吱声。

孟桐妃

笑笑 发表于 2012-4-27 10:12

                               
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他也是算搞IT的，说有什么需要帮忙的尽管吱声。

不错不错

nqwang

笑笑 发表于 2012-4-27 10:12

                               
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他也是算搞IT的，说有什么需要帮忙的尽管吱声。

被出卖了，俺说话算话。

nqwang

Preparing for your appointment

Because a low platelet count may not cause symptoms, the problem is often discovered when you have a blood test for another reason. If your doctor thinks you might have ITP, you are likely to have further blood tests that require drawing a small amount of blood from a vein in your arm. You are also likely to be referred to a doctor who specializes in blood disorders (hematologist) for further evaluation and treatment.

Appointments, even with specialists, can be brief, and there's often a lot of ground to cover, so it can help to be prepared. Here are some tips to help you get ready for your appointment:

What you can do

• Write down all your symptoms — even those that seem unrelated to your current problem. Include key personal information, such as major stresses or recent life changes.
• Make a list of all medications, including vitamins, herbs and over-the-counter drugs, that you're taking. Even better, take the original bottles and a written list of the dosages and directions.
• Take along a family member or friend. It can be difficult to absorb all the information provided during an appointment. The person who accompanies you may remember something that you forgot or missed.
• Write down questions for your doctor. Don't be afraid to ask questions or to speak up when you don't understand something your doctor says. Start with the problems that concern you most. If you run out of time, ask to speak with a nurse or physician's assistant or leave a message for your doctor.
  

Questions you may want to ask include:

• What tests are needed to confirm the diagnosis?
• Is this condition temporary or long-lasting?
• What treatments are available and what do you recommend?
• What will happen if I do nothing?
• What are the possible side effects of the treatments you're suggesting?
• How can I avoid those side effects?
• Can you refer me to a website or other source, so I can learn more about this condition?
  

如何准备检查

因为低血小板计数不会引起任何症状，所以问题通常是在其他原因的血液检查中发现的。如果你的医生认为你可能患有ITP，你可能需要更进一步的血液检查，或者需要去血液科做进一步的检查和治疗。

预约检查，即使是专家，也是很短点的，所以你需要在检查前做好准备。以下是一些小贴士，希望可以帮助你面对ITP检查：

你可以做什么

• 记录你的病症 - 即使是一些以前你认为无关的症状，包括个人信息，最近生活的变化。
• 用药记录 - 包括维生素，中药，正在服用的非处方药，如果可以保留原来的包装，记录服用的计量，那将会更好。
• 与家庭成员或朋友一起 - 自己很难可以记住所有的情况，陪伴你的人也许可以更正或帮助你想起你忘记的信息。
• 写下问题 - 当你不明白你医生说的东西，不要害怕提问或者讲话。要问清楚你最想知道的问题，如果时间有限，你可以问护士或者助理医生，或者把你的问题写下来，留给医生。
  

你可能要问的问题

• 需要什么样的检查已确认病情？
• 是短期的还是长期的？
• 有什么样的治疗手段，医生推荐采用什么样的治疗方法？
• 如果我不治疗，会发生什么情况？
• 医生所采用的治疗方案有什么副作用？
• 我如何避免这些副作用？
• 我可以从什么网站或地方了解更多的信息？
  

芽芽

Mayo是世界著名的医院呢! 多谢提供这些有用的信息

nqwang

Tests and diagnosis

Doctors usually diagnose idiopathic thrombocytopenic purpura by excluding other possible causes of bleeding and a low platelet count, such as an underlying illness or medications you may be taking. If no other underlying problem is causing your signs and symptoms, then a diagnosis of ITP may be made.

To diagnose ITP, your doctor may need a:

• Physical exam, including a complete medical history. Your doctor will look for signs of bleeding under your skin, and will ask you about previous illnesses you've had and the types of medications and supplements that you've recently taken.
• Complete blood count. This common blood test is used to determine the number of white and red blood cells and platelets in a sample of your blood. With ITP, white and red blood cell counts are usually normal, but the platelet count is low.
• Blood smear. A sample of your blood is placed on a slide and observed under a microscope. This test is often used to confirm the number of platelets observed in a complete blood count.
• Bone marrow examination. Another test that may help identify the cause of a low platelet count is a bone marrow exam. Platelets are produced in your bone marrow — soft, spongy tissue in the center of your large bones. In some cases, a sample of solid bone marrow is removed in a procedure called a bone marrow biopsy. Or, you may have a bone marrow aspiration, which removes the liquid portion of your marrow. In many cases, both procedures are performed at the same time (bone marrow exam). Both the liquid and solid bone marrow samples are frequently taken from the same place on the back of one of your hipbones. A needle is inserted into the bone through an incision. If you have ITP, your bone marrow will be normal because your low platelet count is caused by the destruction of platelets in your bloodstream and spleen — not by a problem with the bone marrow.
  

诊断

医生通常通过排除其他可能引起出血和低血小板计数来诊断ITP，例如潜在的疾病或者你正在服用的某些药物。如果没有其他潜在的原因引起病症，然后会诊断你可能有ITP。
诊断ITP患者，医生可能需要：

• 体检，包括完整的用药记录。你的医生会观察你皮下出血的情况，问你过去患有的疾病，以及你曾经或正在服用的药物。
• 血常规检查。这是一种常用的血液检查用来确定你的血液样本中白细胞，血红细胞，以及血小板的数量。ITP患者中，白细胞和血红细胞数量一般正常，但血小板计数偏低。
• 血液涂片。通过显微镜观察你的血液样本。这种检查经常用来确认在一个完整的血球计数中的血小板计数。
• 骨髓检查。这种检查可以帮助确定低血小板计数的原因。血小板是在骨头中心的骨髓海绵组织中产生。在一些情况下，你需要做骨髓活检，或者你可能需要做骨髓穿刺，从你的骨髓也中取部分骨髓液。无论是骨髓液还是骨髓样本，通常是从同一个地方采取，就是在你的髋骨将骨针插入。如果你患有ITP，那么你的骨髓将是正常的，因为你的低血小板计数是在你的血液和脾脏中破坏的，而不是在骨髓中存在问题。
  

Delta

Pretty good, thanks!

Delta

Treatments and drugs

The goal of treating ITP is to ensure a safe platelet count and prevent bleeding complications while minimizing treatment side effects.

In children, idiopathic thrombocytopenic purpura usually runs its course without the need for treatment. About 80 percent of children with idiopathic thrombocytopenic purpura recover completely within six months. Even in children who develop chronic ITP, complete recovery may still occur, even years later.

Adults with mild cases of ITP may require nothing more than regular monitoring and platelet checks. But if your symptoms are troublesome and your platelet count remains low, you and your doctor may opt for treatment. Treatment usually consists of medications and sometimes surgery (splenectomy). Your doctor may also have you discontinue certain drugs that can further inhibit platelet function, such as aspirin, ibuprofen (Advil, Motrin, others) and the blood-thinning medication warfarin (Coumadin).

治疗和药物

治疗ITP的目标就是确保一个安全的血小板计数和阻止出血并发症，与此同时需要尽可能减少治疗的副作用。

对于儿童来说，ITP通常无需治疗可以自愈。大约80%的儿童ITP患者在六个月内能完全恢复。甚至是那些患有慢性ITP的儿童，完全康复的可能性也会发生，甚至是患病很多年了。

有轻微症状的成年ITP患者只需要做一些定期监测和血小板检查即可。但是如果你的症状非常的明显并且你的血小板计数一直比较低的话，你和你的医生应该选择治疗了。治疗通常包括药物治疗并且有时会是外科手术治疗（脾切除术）。你的医生也会让你停用一些能进一步抑制血小板功能的特别的药物，比如阿司匹林，布洛芬（艾德维尔， Mortin（一种药品布洛芬品牌）其它等等）以及一些活血的药物阻凝剂（香豆素）。

Delta

Medications

Common medications used to treat idiopathic thrombocytopenic purpura include:
•        Corticosteroids. The first line of therapy for ITP is a corticosteroid, usually prednisone, which can help raise your platelet count by decreasing the activity of your immune system. Once your platelet count is back to a safe level, you can gradually discontinue taking the drug under the direction of your doctor. In general, this takes about two to six weeks.
The problem is that many adults experience a relapse after discontinuing corticosteroids. A new course of corticosteroids may be pursued, but long-term use of these medications isn't recommended because of the risk of serious side effects, including cataracts, high blood sugar, increased risk of infections and loss of calcium from your bones (osteoporosis). You and your doctor will want to weigh the benefits of the medication against these risks. If you've taken corticosteroids for longer than three months, your doctor will likely recommend that you take calcium and vitamin D supplements to help maintain your bone density.
•        Intravenous immune globulin (IVIG). If you have critical bleeding or need to quickly increase your blood count before surgery, you may receive medications, such as immune globulin, given intravenously. These medications are quick and effective, but the effect usually wears off in a couple of weeks. Possible side effects include headache, nausea and vomiting.
•        Thrombopoietin receptor agonists. The newest medications approved to treat ITP are romiplostim (Nplate) and eltrombopag (Promacta). These drugs help your bone marrow produce more platelets, which helps prevent bruising and bleeding. Possible side effects include headache, joint or muscle pain, dizziness, nausea or vomiting, and an increased risk of blood clots.

•        药物治疗

用于治疗ITP的常用药物包括：
         (肾上腺)皮质激素类. ITP的首选疗法就是糖皮质激素，通常是强的松，一种通过减少你的免疫系统的活动来帮助提高你的血小板数量的药物。一旦你的血小板数量回归到了安全值，你就可以在你医生的指导下逐步地减少药物的服用。通常来讲，这个过程大约需要两到六周。

        问题是当停用激素类的药物后很多成年人都会复发。一个关于皮质激素类药物的新的课题可能需要继续研究，但并不推荐长期服用这些药物，因为有严重的副作用风险，包括白内障，高血糖，增加了传染病的风险和骨头里的钙的流失（骨质疏松症）。你和你的医生需要权衡一下药物治疗和这些风险的利与弊。如果你已经服用了激素类药物超过了三个多月，你的医生很可能会建议你服用些钙片和维他命D的营养品来帮助维护你的骨骼密度。

         静脉注射免疫球蛋白（IVIG）. 如果你有很严重的出血症状或者需要在外科手术前快速的提高你的血小板数量，你可能需要接受这些药物治疗，比如通过静脉注射丙球蛋白。这些药物治疗很快并且很有效，但效果只能维持几周。可能产生的副作用包括头疼，恶心，呕吐。

        促血小板生成素. 已经被认可的治疗ITP的最新药物是罗米司亭和艾曲波帕。这些药物帮助你的骨髓产生更多的血小板，来帮助阻止挫伤和出血。可能的副作用包括头疼，关节或肌肉疼痛，头晕，恶心或呕吐，并且会增加血栓的风险。

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Surgery

If you have severe ITP and an initial course of prednisone hasn't helped, surgical removal of your spleen (splenectomy) may be an option. This eliminates the main source of platelet destruction in your body and improves your platelet count within a few weeks. Splenectomy for ITP is not as routinely performed as it once was, however. Serious post-surgical complications sometimes occur, and not having a spleen permanently increases your susceptibility to infection. What's more, some people relapse even after splenectomy.

Splenectomy is rarely performed in children because of their high rate of spontaneous remission.

手术治疗

如果你患有严重的ITP并且初步的激素治疗方案没有作用的话，手术切除你的脾（脾切除术）也许是个选择。这会消除在你体内的血小板破坏的主要来源并在几周内提高你的血小板计数。然而，对ITP而言，脾切除术并不像以前的老一套的外科手术。严重的术后并发症有时会发生，并且永久的失去一个脾的话会增加容易感染的可能性。更重要的是，很多人即使做了脾切除术仍然会复发。

脾切除术是很少在儿童群体中应用的，因为他们有极高的自愈率。

注：想利用空闲时间帮助王兄翻译完这篇文章，希望能对大家有所帮助！因水平有限，个别翻译难免有偏差，请王兄及各位朋友斧正，以免误导众朋友，谢谢！！

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Emergency treatment

Although rare, severe bleeding can occur with ITP, regardless of age or platelet count. Severe or widespread bleeding is life-threatening and demands emergency care. This usually includes transfusions of platelet concentrates, intravenous methylprednisolone (a type of corticosteroid) and intravenous immune globulin.

紧急治疗

虽然很少见，严重的出血仍然会伴随着ITP发生，无论多大年龄或者血小板的计数如何。严重的或者扩散性的出血会影响生命并且需要紧急救护的。这通常会包括输注浓缩血小板，静脉注射甲强龙（一种激素类药物）和静脉注射丙球蛋白。

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Other treatments

If neither the initial round of corticosteroids nor a splenectomy has helped you achieve remission and your symptoms are severe, your doctor may recommend another course of corticosteroids, usually at the lowest effective dose.
Other possible treatments include:
•        Immunosuppressant drugs. Medications that suppress the immune system, such as rituximab (Rituxan) — the most commonly used of this group — cyclophosphamide (Cytoxan) and azathioprine (Imuran, Azasan), have been used to treat ITP, but they can cause significant side effects, and their effectiveness has yet to be proved.
•        Experimental drugs. New medications that increase platelet production, especially eltrombopag and AMG 531, are being studied in clinical trials. Although they appear to be well tolerated, questions about long-term side effects remain, and relapse is possible when the drugs are stopped.
•        H. pylori treatment. Some people with ITP are also infected with Helicobacter pylori, the same bacteria that cause most peptic ulcers. Eliminating the bacteria has helped increase platelet count in some people, but the results for this therapy are inconsistent and need to be studied further.
Because of the potential complications of both the disease and its treatment, it's important for you and your doctor to carefully weigh the benefits and risks of treatment. For example, some people find that the side effects of treatment are more burdensome than the effects of the disease itself. Treatment decisions are usually based on:
•        Severity of signs and symptoms (active bleeding is usually an indication for treatment)
•        Platelet count — even relatively low counts (less than 30,000 platelets per microliter of blood) may not merit treatment, especially if you have no active bleeding and have a fairly sedentary lifestyle
•        Your age and willingness to undergo treatment
•        Risk of bleeding relative to lifestyle, such as participation in sports or other vigorous physical activities that may predispose you to injury
•        Risk of bleeding based on other medical conditions (high blood pressure, infections, alcoholism, chronic liver disease, peptic ulcer) or needed medications, such as aspirin
•        Potential side effects of ITP therapies

其它的治疗方案

如果经过最初一轮激素治疗跟脾切除术之后，并没有帮你减轻症状，并且你的症状仍然非常严重的话，你的医生可能会推荐你其它的一些激素治疗方案，而且通常是小剂量的。
其它可能的治疗方案包括：
•        免疫抑制药物 这些药物通常会抑制免疫系统，比如美罗华---在这组药物中最常用的---环磷酰胺和咪唑硫嘌呤，也已经被用来治疗ITP。但是它们会导致很明显的副作用，而且它们的疗效还有待验证。
•        实验药物 新的药物会增加血小板的产生，特别是伊屈泼帕和AMG531已经在临床实验中被研究。虽然它们看起来似乎是可以接受的，但存在的问题是长期服用的副作用和停药后复发的可能性。
•        幽门螺杆菌治疗 有些ITP患者也会同时感染幽门螺杆菌，同样的细菌可能会导致大多数的胃溃疡。消除这种细菌在某些特定人群中能帮助提高血小板的数量，但是这种疗法的结果是前后矛盾的，需要进一步的研究。
由于这种疾病和其治疗方案存在着潜在的并发症，你和你的医生权衡治疗方案的利与弊是非常重要的。例如有些人会发现治疗带来的副作用会比疾病本身更烦人。
治疗方案的决定通常依据于：
•        严重的迹象和症状（活动性出血往往是需要治疗的一个迹象）
•        血小板计数----即使相对比较少的计数（少于3万血小板每微升血液）可能都不值得治疗，尤其是如果你没有活动性出血并且有一种相当久坐不动的生活方式。（此处应该是说如果血小板比较少但是平时不怎么剧烈运动的话）
•        你的年龄和意愿能够承受治疗
•        出血的风险跟生活方式有关，比如参加一些运动或者其它一些可能会导致你受伤的剧烈的体育活动
•        出血的风险还基于其它的一些健康状况（高血压，传染病，酗酒，慢性肝病，消化性溃疡）或者服用的药物，比如阿司匹林
•        ITP疗法潜在的副作用

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Lifestyle and home remedies

If you have idiopathic thrombocytopenic purpura, the following steps may help control your risk of bleeding and other complications:
•        Avoid platelet-impairing medications. Over-the-counter drugs, such as aspirin and ibuprofen (Advil, Motrin, others), can impair platelet function.
•        Limit alcohol. Excessive alcohol intake can adversely affect blood clotting.
•        Choose low-impact physical activities. Your doctor may recommend avoiding competitive sports or other activities that might increase the risk of injury and bleeding.
•        Watch for signs of infection. If you've had your spleen removed, be alert for any signs of infection, including fever, and seek prompt treatment. Infection in someone who's had a splenectomy may be more severe, last longer and have more serious implications than in someone who still has an intact spleen.

生活方式和家庭护理

如果你患有ITP，接下来的几步可能会帮助控制你出血的风险和其它的并发症：
•        避免血小板损害的药物. 不需要处方而销售的药物，比如阿司匹林和布洛芬，可以损害血小板的功能
•        禁酒. 过度的酒精摄入会严重影响凝血功能.
•        选择低强度的体育运动. 你的医生可能会建议你避免竞技类的体育运动或者其它的一些可能增加损伤或出血风险的活动.
•        观察感染的迹象. 如果你已经把你的脾切除了，需要警惕一些感染迹象，包括感冒发烧，需要寻求及时的治疗。感染可能对那些做了脾切除术的人群来说会更严重，相比那些仍然拥有完整脾的人来说感染会持续的更久，并且会有更严重的影响。

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http://www.pdsa.org 通过王兄链接的网站发现了个国外的ITP患者网站，有英语功底的朋友可以去看看，一起找些有价值的文章，转过来给大家参考！！！

问问问

咱家园里人才济济啊！！