Efectividad de los esquemas de tratamiento en trombocitopenia inmune usados por el Servicio de Hematología del Hospital Luis Vernaza, período 2014-2015
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Introducción: La trombocitopenia inmune primaria es un trastorno autoinmune adquirido, caracterizado por una disminución transitoria o persistente del recuento de plaquetas con riesgo incrementado de sangrados. La forma crónica de la enfermedad afecta fundamentalmente a los adultos. Puesto que las remisiones espontáneas son muy poco frecuentes, los pacientes son tratados desde el inicio, usualmente con esteroides. Objetivos: Se plantearon los siguientes objetivos: Determinar el porcentaje de respuesta a las líneas de tratamiento en pacientes con Trombocitopenia Inmune. Determinar el recuento plaquetario en los pacientes que recibieron terapia de primera línea. Evaluar el porcentaje de respuesta a la terapia de primera línea. Cuantificar el porcentaje de complicaciones a corto plazo presentes en pacientes con Trombocitopenia Inmune tratados con terapia de primera línea. Materiales y métodos: Es un estudio descriptivo de corte transversal, retrospectivo, no experimental, realizado a los pacientes del Hospital Luis Vernaza con diagnóstico de Trombocitopenia Inmune en el servicio de Hematología. El universo fueron todos los pacientes atendidos por el del servicio de Hematología, desde Enero del 2014 hasta Diciembre del 2015. La población estuvo constituida por todos los pacientes portadores de Trombocitopenia de etiología inmunológica. No se muestreo, ya que se utilizó a toda la población como sujeto de estudio. Resultados: De los 42 pacientes del proyecto de investigación, 29 (69%) respondieron a la primera línea de tratamiento, 9(21%) a la segunda línea y 4(10%) a la tercera línea; El análisis estadístico reporto: Chi X2: 10, P: 0,001, OR: 14, IC: 2.8-68.3/ 95%, Test Student: 0,000000000003. En lo concerniente al tipo de respuesta a la primera línea, 7 (17%) presentaron respuesta completa, 22(52%) respuesta parcial. En cuanto a las complicaciones, 12(28%) presentaron hiperglicemia, 7(17%) síntomas gastrointestinales y 2(5%) insomnio; El análisis estadístico reporto: un RR: 5 (1.3521.3). La mayoría de pacientes aumentaron 3.5 veces sus valores de plaquetas con la primera línea de tratamiento. Conclusiones: La mayoría de pacientes con Trombocitopenia inmune respondieron a la primera línea terapéutica. La mayoría de los pacientes con trombocitopenia inmune presentaron respuesta parcial a la primera línea de tratamiento. La complicación más frecuente en pacientes que recibieron la primera línea de tratamiento fue la hiperglicemia. La mayoría de pacientes con Trombocitopenia inmune que recibieron la primera línea de tratamiento triplicaron su recuento plaquetario.
Introduction: Primary immune thrombocytopenia is an acquired autoimmune disorder characterized by a transient or persistent decrease in platelet count with increased risk of bleeding. The chronic form of the disease primarily affects adults. Since spontaneous remissions are very rare, patients are treated from the beginning, usually with steroids. Objectives: The following objectives were set: To determine the response rate to treatment lines in patients with Immune Thrombocytopenia. To determine the platelet count in patients receiving first-line therapy. Evaluate the response rate to first-line therapy. To quantify the percentage of short-term complications present in patients with Immune Thrombocytopenia treated with first-line therapy. Materials and methods: The present research project is a cross-sectional, retrospective, non-experimental, study carried out on the patients of the Luis Vernaza Hospital with diagnosis of Immune Thrombocytopenia in the Hematology department. The universe was all patients attended by the Hematology service, from January 2014 to December 2015. The population was constituted by all patients with thrombocytopenia of immunological etiology. We did not sample, since the entire population was used as the subject of study. Results: Of the 42 patients in the research project, 29 (69%) responded to the first line of treatment, 9 (21%) to the second line and 4 (10%) to the third line; The statistical analysis reported a:Chi X2: 10, P: 0,001, OR: 14, IC: 2.8-68.3/ 95%, Test Student: 0,000000000003.Regarding the type of response to the first line, 7 (17%) presented complete response, 22 (52%) partial response. As for complications, 12 (28%) presented hyperglycemia, 7 (17%) gastrointestinal symptoms and 2 (5%) insomnia; The statistical analysis reported a RR: 5 (1.35-21.3). The majority of patients increased their platelet values by 3.5 times with the first line of treatment. Conclusions: The majority of patients with immune thrombocytopenia responded to the first therapeutic line. Most patients with immune thrombocytopenia presented partial response to the first line of treatment. The most frequent complication in patients receiving the first line of treatment was hyperglycemia. Most patients with immune thrombocytopenia who received the first line of treatment tripled their platelet count.
Introduction: Primary immune thrombocytopenia is an acquired autoimmune disorder characterized by a transient or persistent decrease in platelet count with increased risk of bleeding. The chronic form of the disease primarily affects adults. Since spontaneous remissions are very rare, patients are treated from the beginning, usually with steroids. Objectives: The following objectives were set: To determine the response rate to treatment lines in patients with Immune Thrombocytopenia. To determine the platelet count in patients receiving first-line therapy. Evaluate the response rate to first-line therapy. To quantify the percentage of short-term complications present in patients with Immune Thrombocytopenia treated with first-line therapy. Materials and methods: The present research project is a cross-sectional, retrospective, non-experimental, study carried out on the patients of the Luis Vernaza Hospital with diagnosis of Immune Thrombocytopenia in the Hematology department. The universe was all patients attended by the Hematology service, from January 2014 to December 2015. The population was constituted by all patients with thrombocytopenia of immunological etiology. We did not sample, since the entire population was used as the subject of study. Results: Of the 42 patients in the research project, 29 (69%) responded to the first line of treatment, 9 (21%) to the second line and 4 (10%) to the third line; The statistical analysis reported a:Chi X2: 10, P: 0,001, OR: 14, IC: 2.8-68.3/ 95%, Test Student: 0,000000000003.Regarding the type of response to the first line, 7 (17%) presented complete response, 22 (52%) partial response. As for complications, 12 (28%) presented hyperglycemia, 7 (17%) gastrointestinal symptoms and 2 (5%) insomnia; The statistical analysis reported a RR: 5 (1.35-21.3). The majority of patients increased their platelet values by 3.5 times with the first line of treatment. Conclusions: The majority of patients with immune thrombocytopenia responded to the first therapeutic line. Most patients with immune thrombocytopenia presented partial response to the first line of treatment. The most frequent complication in patients receiving the first line of treatment was hyperglycemia. Most patients with immune thrombocytopenia who received the first line of treatment tripled their platelet count.
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Púrpura trombocitopénica idiopática, Plaquetas, Epidemiología descriptiva, Estudios retrospectivos, Hospital Luis Vernaza, Cantón Guayaquil, Ecuador