Analysis Of Predictive Factors Concerning Prognosis Of Idiopathic Thrombocytopenic Purpura

Background&Objective At the moment the studies about the predictive factors of pediatric idiopathic thrombocytopenic purpura have been released already inland or abroad.Some scientists discovered that megakaryocytic number of bone marrow has close relationship with prognosis of pediatric ITP and it can be recognized as one of factors judging prognosis.However,adult ITP factors influencing prognosis have been hardly put forward.Now that there is no statistical analysis of large cases until now we cannot make sure of predictive factors about ITP prognosis.The objective of this study is to discuss the interrelated factors affecting the prognosis of idiopathic thrombocy- topenic purpura.Methods To confirm if the factors have relation with the prognosis of ITP which are as follows: the age,age of onset, sex, typing of disease, course of disease, platelet count (Plt) and mean platelet volume, total megakaryocyte count of bone marrow before treatment, days of Plt starting to return and to reach the normal level, to get to the peak value from treatment,different treatment plans with the help of analyzing the clinical data of 221 cases of my hospital with preliminary diagnosis clearly as ITP from 2004. On the basis of the standards Chinese Blood Academy established,the cases were divided into effective group and ineffective group,and then prognosis is estimated by graded table.Results Between Month 2004 and Feburary 2008, there were 221 patients diagnosed clearly as ITP. We divided them into two groups and compared predictive factors concerning prognosis. The effective ratios have significant difference (P=0.011) between adrenal cortical hormone combined with gammaglobulin and single Adrenal cortical hormone and also between adrenal cortical hormone combined with gammaglobulin and with immunodepressants (P=0.016). However, there is no significant meaning between single adrenal cortical hormone and combining with immunodepressants. As a whole, the first one is better than the other two kinds of treatments.Disease typing (P=0.069) and sex (P=0.391) compared failed. The difference of the platelet count peak value (P=0.000) between the two groups was significant, also of the factors such as course of disease (P=0.022) and the returning time of platelet count (P=0.000). The course of disease of effective group is shorter than ineffective one(105.27MRvs127.89MR). All the other factors have the outcomes of P>0.05.We can draw a conclusion as follows: ITP typing (P=0.0329) and platelet count before treatment (P<0.001) are factors concerning prognosis of ITP by statistical analysis. The multivariate stepwise regression equation is as follows: ITP prognosis scores=7.13296+0.64963×typing-0.04843×Plt before treatment (b0=7.13296); Course of disease which was changed into logarithmic form (P= 0.0208) underwent another regression analysis and we also receive another equation: ITP prognosis scores= 6.89754+0.12795×course of disease-0.04870×Plt before treatment(b0=6.89754).Conclusions ITP patients in adults are adviced to choose the treating project that contains gammaglobulin. Early dignosing and treating will help raise the quality of prognosis. The typing of disease and platelet count before treatment have relations with prognosis through analyzing statistically the ITP patients that had been dignosed definitely in our hospital.