Analysis on Curative Effect of Bedside Plasma Exchange in Treatment of Thrombotic Thrombocytopenic Purpura

Objective To observe the clinical curative effect of bedside plasma exchange on treatment of patients with thrombotic thrombocytopenic purpura (TTP).Methods From January 1997 to April 2014,a total of 120 cases of TTP patients who hospitalized in First Affiliated Hospital of Sun Yet-Sen University were collected into this study.They were divided into study group (n=58,accepted conventional treatment and bedside plasma exchange treatment) and control group (n=62,accepted conventional treatment).The curative effect and security of bedside plasma exchange were evaluated.The study protocol was approved by the Ethical Review Board of Investigation in First Affiliated Hospital of Sun Yet-Sen University.Results The alleviation time of anemia,hemolysis,and hospitalization in study group were significantly lower than the control group,with statistically significant difference (t =11.21,16.01,4.86,P =0.000 1,0.000 1,0.000 1).Before treatment,there were no statistical differences of the acute physiology and chronic health evaluation (APACHE) Ⅱ scores between two groups (t=0.84,P=0.40).4 days after treatment,there was statistical difference between two groups of APACHE Ⅱ scores (t=6.39,P＜0.05) and the APACHE Ⅱ scores in both two groups decreased.Before treatment,there were no statistical differences among the levels of plasma D-dimer,thyroglobulin (TG),tumor necrosis factor (TNF)-α,interleukin (IL)-6 between two groups (t=0.71,1.22,0.61,1.00;P=0.47,0.22,0.52,0.31).But 6 days after treatment,there were statistical differences among levels of plasma D-dimer,TG,TNF-α and IL-6 between two groups.And these indicators in study group were significantly lower than those in control group.There were 2 cases of hypotension and 1 case of urticaria occurred in study group,and those in symptoms were alleviated after symptomatic treatment.Conclusions Patients with TTP can benefit from the bedside plasma exchange treatment which is safe and effective,worthy of clinical promotion. Key words: Plasma exchange;  Purpura, thrombotic thrombocytopenic;  Comparative effectiveness research;  Safety