作者：陈涛，屈媛媛，李彬彬，鲁菁，邵玉莹，郭述豪，冯楚文，孙维伯，孙忠人，杨添淞

单位：

1.黑龙江中医药大学研究生院2.黑龙江中医药大学附属第一医院教务科3.哈尔滨医科大学第一临床医学院4.黑龙江中医药大学5.黑龙江中医药大学附属第一医院康复二科6.黑龙江省中医药信息学重点实验室

Units：

1.Graduate School of Heilongjiang University of Chinese Medicine, Harbin 150040, China 2.Department of Academic Affairs, the First Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China 3.The First Clinical Medical of Harbin Medical University, Harbin 150081, China 4.Heilongjiang University of Chinese Medicine, Harbin 150040, China 5.Second Department of Rehabilitation, First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China 6.Key Laboratory of Chinese Medicine Informatics in Heilongjiang Province, Harbin 150040, China

关键词：

缺血性卒中; 血小板减少症; 免疫性血小板减少症; 治疗; 综述;

Keywords：

Ischemic stroke; Thrombocytopenia; Immune thrombocytopenia; Treatment; Review

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.162

Funds：

国家自然科学基金面上项目（82074539）；国家自然科学基金青年项目（81704170）；黑龙江省自然科学基金资助项目（LH2020H092）

摘要：

从流行病学角度分析，急性缺血性卒中（AIS）仍是影响我国乃至全球居民生活质量和身体健康的常见病及多发病。免疫性血小板减少症（ITP）属于血液系统恶性疾病，以血小板减少和自发出血倾向为主要特征，其发病率虽然较低，但该病患者发生AIS的风险更高；且AIS患者经治疗后也会出现血小板减少情况。而AIS的抗凝治疗与ITP的抗出血治疗相矛盾，故缺乏有效的治疗方案，导致该类患者死亡率较高、疗效不佳、预后较差。因此，AIS患者合并ITP时应引起临床医师重视。本文基于流行病学分析了AIS与ITP的发病趋势、ITP增加AIS发病风险的原因/机制，并综述了AIS合并ITP的治疗方案及治疗难点，以期提高临床医生对AIS合并ITP患者的诊治水平。

Abstract：

From an epidemiological analysis, acute ischemic stroke (AIS) remains a major common and frequent disease affecting the quality of life and physical health of the population in China and worldwide. Although the incidence of immune thrombocytopenia (ITP) , a malignant disease of the hematological system characterized by thrombocytopenia and spontaneous bleeding tendency, is low, patients with this disease are at higher risk of AIS; and thrombocytopenia also occurs in patients with AIS after treatment. The anticoagulant therapy of AIS is inconsistent with the anti-bleeding therapy of ITP, so there is no effective treatment, resulting in a high mortality rate, poor outcome, and poor prognosis for this group of patients. Therefore, the combination of ITP in patients with AIS should attract the attention of clinicians. This article analyzes the trend of AIS and ITP based on epidemiology and the reason/mechanism of ITP increasing the risk of AIS, and reviews the treatment options and treatment difficulties of AIS combined with ITP, with the aim of improving clinicians' treatment outcomes for patients with AIS combined with ITP.

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