中国实用妇科与产科杂志2025，Vol.41Issue(9)：890-894,5.DOI:10.19538/j.fk2025090107
妊娠期免疫性血小板减少症与妊娠期血栓性微血管病的鉴别
Immune thrombocytopenia and thrombotic microangiopathy in pregnancy:key strategies for clinical differentiation
摘要
Abstract
Thrombocytopenia is a common hematologic complication during pregnancy,and immune thrombocyto-penia and thrombotic microangiopathy(TMA)are rare but important etiologies,requiring precise differentiation due to their distinct pathological mechanisms,treatment strate-gies,and maternal-fetal risks.Immune thrombocytopenia refers to thrombocytopenia mediated by abnormal immune activation.The diagnosis of primary immune thrombocyto-penia(ITP)should exclude secondary ITP due to other causes(such as autoimmune diseases,infections,drugs,tumors,etc.),and the treatment for ITP primarily involves glucocorticoids and intravenous immunoglobulin.TMA is a group of heterogeneous diseases with the core pathological features of microvascular thrombosis,presenting with mi-croangiopathic hemolysis,thrombocytopenia,and multi-or-gan dysfunction,which requires specific interventions based on different disease types,such as pregnancy termi-nation,plasma exchange,or complement inhibitors.This ar-ticle systematically outlines the key points for differential diagnosis of ITP and TMA based on clinical features,labo-ratory tests and molecular markers,emphasizing the criti-cal importance of initiating targeted therapy promptly in im-proving maternal-fetal prognosis.关键词
免疫性血小板减少症/血栓性微血管病/妊娠并发症/鉴别诊断Key words
immune thrombocytopenia/thrombotic microangiopathy/pregnancy complications/differential diagnosis分类
医药卫生引用本文复制引用
汤萍萍,高劲松..妊娠期免疫性血小板减少症与妊娠期血栓性微血管病的鉴别[J].中国实用妇科与产科杂志,2025,41(9):890-894,5.基金项目
国家重点研发计划(2022YFC2704505) （2022YFC2704505）
北京协和医院中央高水平医院临床科研专项(2022-PUMCH-B-075) National Key Research and Development Program of China(2022YFC2704505) （2022-PUMCH-B-075）
Peking Union Med-ical College Hospital Central High-level Hospital Clinical Scientific Research Project(2022-PUMCH-B-075) （2022-PUMCH-B-075）
