[Summary] What are the treatment methods for thrombocytosis? Shi Shurong’s appointment

Primary thrombocythemia is a type of myeloproliferative disease. The megakaryocytes in the bone marrow of the patient are abnormally proliferated, and the platelet count is significantly increased. And there is a tendency of spontaneous bleeding and thrombosis, more than half of the patients are accompanied by splenomegaly, pulmonary embolism and myocardial infarction, and life-threatening cerebral infarction. Director Shi Shurong’s micro-signal xueyeke999 Therefore, clinical treatment measures should be taken actively to control the abnormal rise in platelet values. The goal of treatment is to effectively reduce platelet values ​​while preventing complications such as thrombosis and bleeding. So, what are the treatment methods for thrombocytosis? The specific treatment methods are summarized as follows: first: myelosuppressive drug hydroxyurea: currently one of the first drugs for the treatment of this disease at home and abroad, it can reduce the platelet value to less than 400, and the effective rate reaches about 80%. . Side effects: Reversible white blood cell reduction, long-term application due to the inhibitory effect on DNA, may appear red blood cell megaloblastic phenomenon. Some patients have skin and mucous membrane damage, such as increased pigmentation, maculopapular rash, purple papules, nail atrophy, oral ulcers, and gastrointestinal discomfort. Baixiaoan: It is a commonly used drug for this disease, and a small dose should be used. When the platelet is reduced to 50% of the initial treatment, the dose is also reduced by half. It is now used sparingly. Nitrogen mustard: used in combination with platelet harvesting in severely ill patients with thrombosis, followed by platelet harvesting. After clinical improvement, other bone marrow suppressive drugs are selected for maintenance. Other myelosuppressive drugs include cyclophosphamide, chlorambucil, levamisole, etc. Second: Anagrelide Anagrelide can inhibit cyclic ribose phosphodiesterase and phosphatase A2. In the early stage, it was mainly used as a platelet aggregation inhibitor in clinical practice. Later, it was found that its platelet-reducing effect was more prominent. Its mechanism of action is to selectively act on megakaryocytes, reduce platelets by preventing megakaryocytes from maturing, and have a therapeutic effect on various MPDs with increased platelets. This medicine has fewer side effects. Third: Radionuclide 32P can be taken orally or intravenously. If necessary, administer the medicine again after 3 months. It is generally not recommended for patients under 45 years of age, because 32P may have a potential role in inducing leukemia. Fourth: Interferon Interferon-α has a significant effect of inhibiting the proliferation of BFU-MK and CFU-MK in vivo and in vitro, and can effectively reduce the incidence of thrombosis and bleeding complications. Its mechanism of action is related to its dual effect of reducing platelet levels and enhancing platelet function. The application of this drug requires adjustment of the dosage according to the patient’s tolerance and treatment effect. At the same time, long-term maintenance treatment is required. The side effects are lighter, and the long-term effects also need to vary from person to person. Fifth: platelet apheresis is platelet separation, using Xu cell separation to separate platelets to achieve the purpose of rapidly reducing the number of platelets and improving clinical symptoms. This method is mostly used in elderly patients with acute gastrointestinal bleeding, before pregnancy and childbirth, before selective surgery, and when current myelosuppressive drugs cannot work. After the apheresis, the platelet value decreased significantly, and then the patient can be treated with drug maintenance, which is a transient treatment. Sixth: Integrated Chinese and Western medicine treatment Chinese medicine has certain advantages in the treatment of this disease and the prevention of complications, but the condition of patients with thrombocytosis continues to progress, and it is difficult for simple Chinese medicine treatment to have obvious effects. Although it can control the condition of the disease, it needs long-term medication, and it will inevitably have certain side effects on the patient’s body. Therefore, in the treatment of thrombocytosis, the combination of traditional Chinese and Western medicine therapy is used. Taking full advantage of the two can better control the abnormal rise of platelet values, achieve disease relief, reduce the occurrence of complications, improve the efficacy, and improve the quality of life of patients. [For more disease knowledge, follow WeChat public account: thrombocythemia patient association] Welcome to follow Shi Shurong to consult and reserve the public account to learn more: zzb753