Am J Gastroenterol:血小板计数不能预测肝硬化患者是否发生出血

2018-01-23 MedSci MedSci原创

血小板计数不能预测肝硬化患者是否发生大出血或轻微出血事件。

血小板减少症是肝硬化患者的标志,被认为是出血事件的危险因素。然而,目前仍不清楚血小板计数减少与肝硬化患者发生出血是否相关。

研究利用4年的随访时间,调查血小板计数与主要或临床相关非主要出血的关系。

研究共纳入280例肝硬化患者,其中,67%的患者为男性,平均年龄为64±37岁,47%的患者为Child-Pugh B和C级。研究中位随访时间为1,129天。任何明显出血的比率为5.45%/年(较大和轻微出血比率分别为3.57%/年和1.89%/年)。52例(18.6%)患者发生大(n=34)或轻微(n=18)出血事件,主要来自胃肠道出血。随着肝病的恶化,血小板计数逐渐减少;这种情况在出血与未出血患者中没有显著差异。3例患者(6%)检测到血小板计数≤50 x10(3)/mul,20例患者(9%)未发生过出血。相反,整体或大出血患者中,凝血酶原时间-国际标准化比率略高。Cox比例风险分析表明,只有上消化道出血(危险比(HR): 1.96; 95%置信区间: 1.11-3.47; P=0.020)和脑病变两个因素(HR: 2.05; 95%置信区间: 1.16-3.62; P=0.013)能够独立预测出血事件。

血小板计数不能预测肝硬化患者是否发生大出血或轻微出血事件。

原始出处

Basili S, Raparelli V, Napoleone L, et al. Platelet Count Does Not Predict Bleeding in Cirrhotic Patients: Results from the PRO-LIVER Study. Am J Gastroenterol Hepatol, 2017, Dec 20. doi: 10.1111/jgh.14075.

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    2018-12-26 许安
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    2018-07-17 zhaojie88
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