慢性肝病血液学异常的研究

T. RajkumarSolomon, A. Aravind, K. CarolineSelvi, R. Balamurali, G. Ramkumar, K. Muthukumuran, C. Vaishnavipriyaa, S. Kavitha, A. Anand, L. JoeimonJ, K. Mohanraj, Karthikeyan Rk, J. Kayalvizhi
{"title":"慢性肝病血液学异常的研究","authors":"T. RajkumarSolomon, A. Aravind, K. CarolineSelvi, R. Balamurali, G. Ramkumar, K. Muthukumuran, C. Vaishnavipriyaa, S. Kavitha, A. Anand, L. JoeimonJ, K. Mohanraj, Karthikeyan Rk, J. Kayalvizhi","doi":"10.9790/0853-1606143844","DOIUrl":null,"url":null,"abstract":"Aim Of The Study: To assess the hematological profile of patients with chronic liver disease and their correlation in patients with GI Bleed. Materials And Methods: To assess the hematological abnormalities in chronic liver disease, a cross sectional analytical study was conducted All patients taken up for the study were evaluated in detail. Oral consent was obtained for clinical examination and lab investigations. Written consent was obtained for procedures such paracentesis, Upper GI endoscopy and viral marker studies. Inclusion Criteria 1. All patients with liver disease whose symptoms and signs persists for more than 6 months 2. Alcoholic cirrhosis, post-necrotic cirrhosis, metabolic causes of liver diseases were taken up for the study Exclusion Criteria 1. Patients with underlying malignancy or known primary hepatocellular carcinoma were excluded 2. Patients with primary coagulation disorder or primary abnormalities of haemostatic function were excluded. 3. Acute hepatic failure was excluded 4. Patients with preexisting anemia due to other causes were excluded. 5. Patients suffering from end stage medical diseases like COPD, Coronary artery disease, cardiac failure, CKD were excluded Observation & Data Analysis: A descriptive study to assess the hematological abnormalities in chronic liver disease was conducted at Department of Digestive Health and diseases, Kilpauk medical college , Chennai from August 2016 to January 2017. 50 patients with chronic liver disease were taken for the study; this included 43 males (86%) and 7 females (14 %). The age range was from 24 to 70. The average age of the patients in the study was 48 yrs. 70 % of the patients were between 40 and 60 years. 52% of the patients had alcoholic cirrhosis were males. The aetiology of chronic liver disease could not be determined in 24 % of cases but all of them had clinical and radiological features of cirrhosis. 6 patients had Hepatitis B and 2 had Hepatitis C; all these 8 patients had cirrhosis. Autoimmune hepatitis and cirrhosis were present in 2 females Results: 50 % of the patients had thrombocytopenia (<1 lakh). Of the 13 patients who had an upper GI bleed 3 patients had normal platelet counts and the rest had counts below 1 lakh. The average platelet count of patients who experienced an upper GI bleed was 92000 vs. 1.2 lakh in patients without a GI bleed. The bleeding time was prolonged only in 6 patients with thrombocytopenia indicating BT as an insensitive test. 36 patients had a prolonged INR. Among the 13 patients with upper GI bleed 9 had prolonged INR; indicating other factors play a role in GI bleed Conclusions: Many conclusive results regarding the hematological abnormalities in chronic liver disease were obtained with this limited study involving 50 patients with cirrhosis ⇒ 50 % of patients had thrombocytopenia. ⇒ The average platelet count of patients with an upper GI bleed was 92000 compared to 1.2 lakh to those without an upper GI bleed; suggesting other factors such functional platelet defects may play a role as well. These need to be confirmed with platelet functional studies. ⇒ Bleeding time was prolonged only in 12 % of patients with thrombocytopenia indicating BT as an insensitive test of platelet number and function. ⇒ The PT-INR was elevated in 72 % of patients. However only 25 % of patients with a prolonged PT-INR had upper GI bleed indicating other factors such as a rebalanced hemostatic system at work, however this A Study on Hematological Abnormalities in Chronic Liver Isease DOI: 10.9790/0853-1606143844 www.iosrjournals.org 39 | Page needs to be confirmed with more extensive studies. This result underlines the fact that clinical status of the patient and not lab values have to be treated, when correcting coagulopathy in a patient with cirrhosis. From this study we can conclude that various hematological alterations are very common in cirrhosis patients that needs to be identified and corrected early to reduce morbidity and mortality.","PeriodicalId":14489,"journal":{"name":"IOSR Journal of Dental and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"9","resultStr":"{\"title\":\"A Study on Hematological Abnormalities in Chronic Liver Diseases\",\"authors\":\"T. RajkumarSolomon, A. Aravind, K. CarolineSelvi, R. Balamurali, G. Ramkumar, K. Muthukumuran, C. Vaishnavipriyaa, S. Kavitha, A. Anand, L. JoeimonJ, K. Mohanraj, Karthikeyan Rk, J. Kayalvizhi\",\"doi\":\"10.9790/0853-1606143844\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim Of The Study: To assess the hematological profile of patients with chronic liver disease and their correlation in patients with GI Bleed. Materials And Methods: To assess the hematological abnormalities in chronic liver disease, a cross sectional analytical study was conducted All patients taken up for the study were evaluated in detail. Oral consent was obtained for clinical examination and lab investigations. Written consent was obtained for procedures such paracentesis, Upper GI endoscopy and viral marker studies. Inclusion Criteria 1. All patients with liver disease whose symptoms and signs persists for more than 6 months 2. Alcoholic cirrhosis, post-necrotic cirrhosis, metabolic causes of liver diseases were taken up for the study Exclusion Criteria 1. Patients with underlying malignancy or known primary hepatocellular carcinoma were excluded 2. Patients with primary coagulation disorder or primary abnormalities of haemostatic function were excluded. 3. Acute hepatic failure was excluded 4. Patients with preexisting anemia due to other causes were excluded. 5. Patients suffering from end stage medical diseases like COPD, Coronary artery disease, cardiac failure, CKD were excluded Observation & Data Analysis: A descriptive study to assess the hematological abnormalities in chronic liver disease was conducted at Department of Digestive Health and diseases, Kilpauk medical college , Chennai from August 2016 to January 2017. 50 patients with chronic liver disease were taken for the study; this included 43 males (86%) and 7 females (14 %). The age range was from 24 to 70. The average age of the patients in the study was 48 yrs. 70 % of the patients were between 40 and 60 years. 52% of the patients had alcoholic cirrhosis were males. The aetiology of chronic liver disease could not be determined in 24 % of cases but all of them had clinical and radiological features of cirrhosis. 6 patients had Hepatitis B and 2 had Hepatitis C; all these 8 patients had cirrhosis. Autoimmune hepatitis and cirrhosis were present in 2 females Results: 50 % of the patients had thrombocytopenia (<1 lakh). Of the 13 patients who had an upper GI bleed 3 patients had normal platelet counts and the rest had counts below 1 lakh. The average platelet count of patients who experienced an upper GI bleed was 92000 vs. 1.2 lakh in patients without a GI bleed. The bleeding time was prolonged only in 6 patients with thrombocytopenia indicating BT as an insensitive test. 36 patients had a prolonged INR. Among the 13 patients with upper GI bleed 9 had prolonged INR; indicating other factors play a role in GI bleed Conclusions: Many conclusive results regarding the hematological abnormalities in chronic liver disease were obtained with this limited study involving 50 patients with cirrhosis ⇒ 50 % of patients had thrombocytopenia. ⇒ The average platelet count of patients with an upper GI bleed was 92000 compared to 1.2 lakh to those without an upper GI bleed; suggesting other factors such functional platelet defects may play a role as well. These need to be confirmed with platelet functional studies. ⇒ Bleeding time was prolonged only in 12 % of patients with thrombocytopenia indicating BT as an insensitive test of platelet number and function. ⇒ The PT-INR was elevated in 72 % of patients. However only 25 % of patients with a prolonged PT-INR had upper GI bleed indicating other factors such as a rebalanced hemostatic system at work, however this A Study on Hematological Abnormalities in Chronic Liver Isease DOI: 10.9790/0853-1606143844 www.iosrjournals.org 39 | Page needs to be confirmed with more extensive studies. This result underlines the fact that clinical status of the patient and not lab values have to be treated, when correcting coagulopathy in a patient with cirrhosis. From this study we can conclude that various hematological alterations are very common in cirrhosis patients that needs to be identified and corrected early to reduce morbidity and mortality.\",\"PeriodicalId\":14489,\"journal\":{\"name\":\"IOSR Journal of Dental and Medical Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"9\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IOSR Journal of Dental and Medical Sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.9790/0853-1606143844\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IOSR Journal of Dental and Medical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.9790/0853-1606143844","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 9

摘要

研究目的:评估慢性肝病患者的血液学特征及其与胃肠道出血患者的相关性。材料与方法:为了评估慢性肝病的血液学异常,我们进行了一项横断面分析研究,对所有纳入研究的患者进行了详细评估。获得临床检查和实验室调查的口头同意。对穿刺、上消化道内窥镜检查和病毒标记物研究等程序获得书面同意。纳入标准所有症状和体征持续6个月以上的肝病患者2。酒精性肝硬化、坏死后肝硬化、肝脏疾病的代谢性原因被纳入研究排除标准1。排除有潜在恶性肿瘤或已知原发性肝细胞癌的患者。排除原发凝血障碍或原发止血功能异常的患者。3.排除急性肝衰竭4。排除其他原因导致的既往贫血患者。5. 排除COPD、冠心病、心力衰竭、CKD等终末期内科疾病患者。观察与数据分析:2016年8月至2017年1月,在金奈Kilpauk医学院消化健康与疾病科进行了一项描述性研究,评估慢性肝病患者的血清学异常。研究对象为50例慢性肝病患者;其中包括43名男性(86%)和7名女性(14%)。年龄范围从24岁到70岁。研究中患者的平均年龄为48岁。70%的患者年龄在40 - 60岁之间。52%的酒精性肝硬化患者为男性。24%的慢性肝病病因不明,但均具有肝硬化的临床和影像学特征。乙型肝炎6例,丙型肝炎2例;8例患者均有肝硬化。2例女性存在自身免疫性肝炎和肝硬化。结果:50%的患者有血小板减少(< 10万)。13例上消化道出血患者中,3例血小板计数正常,其余血小板计数低于10万。经历过上消化道出血的患者平均血小板计数为92000,而没有胃肠道出血的患者平均血小板计数为12万。只有6例血小板减少患者出血时间延长,表明BT是一种不敏感的试验。36例患者INR延长。13例上消化道出血患者中9例有延长的INR;结论:在这项涉及50例肝硬化患者的有限研究中,获得了许多关于慢性肝病血液学异常的结论性结果。50%的患者有血小板减少。⇒上消化道出血患者的平均血小板计数为92000,而没有上消化道出血的患者的平均血小板计数为12万;提示其他因素如功能性血小板缺陷也可能起作用。这些需要通过血小板功能研究来证实。⇒只有12%的血小板减少症患者出血时间延长,这表明BT是血小板数量和功能的不敏感试验。72%的患者PT-INR升高。然而,只有25%的PT-INR延长患者有上消化道出血,这表明其他因素,如重新平衡的止血系统在起作用,然而,这项关于慢性肝病血液学异常的研究DOI: 10.9790/0853-1606143844 www.iosrjournals.org 39 | Page需要更广泛的研究来证实。这一结果强调了这样一个事实,即在纠正肝硬化患者的凝血功能障碍时,必须治疗患者的临床状态而不是实验室值。从这项研究中我们可以得出结论,各种血液学改变在肝硬化患者中很常见,需要及早发现和纠正,以降低发病率和死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Study on Hematological Abnormalities in Chronic Liver Diseases
Aim Of The Study: To assess the hematological profile of patients with chronic liver disease and their correlation in patients with GI Bleed. Materials And Methods: To assess the hematological abnormalities in chronic liver disease, a cross sectional analytical study was conducted All patients taken up for the study were evaluated in detail. Oral consent was obtained for clinical examination and lab investigations. Written consent was obtained for procedures such paracentesis, Upper GI endoscopy and viral marker studies. Inclusion Criteria 1. All patients with liver disease whose symptoms and signs persists for more than 6 months 2. Alcoholic cirrhosis, post-necrotic cirrhosis, metabolic causes of liver diseases were taken up for the study Exclusion Criteria 1. Patients with underlying malignancy or known primary hepatocellular carcinoma were excluded 2. Patients with primary coagulation disorder or primary abnormalities of haemostatic function were excluded. 3. Acute hepatic failure was excluded 4. Patients with preexisting anemia due to other causes were excluded. 5. Patients suffering from end stage medical diseases like COPD, Coronary artery disease, cardiac failure, CKD were excluded Observation & Data Analysis: A descriptive study to assess the hematological abnormalities in chronic liver disease was conducted at Department of Digestive Health and diseases, Kilpauk medical college , Chennai from August 2016 to January 2017. 50 patients with chronic liver disease were taken for the study; this included 43 males (86%) and 7 females (14 %). The age range was from 24 to 70. The average age of the patients in the study was 48 yrs. 70 % of the patients were between 40 and 60 years. 52% of the patients had alcoholic cirrhosis were males. The aetiology of chronic liver disease could not be determined in 24 % of cases but all of them had clinical and radiological features of cirrhosis. 6 patients had Hepatitis B and 2 had Hepatitis C; all these 8 patients had cirrhosis. Autoimmune hepatitis and cirrhosis were present in 2 females Results: 50 % of the patients had thrombocytopenia (<1 lakh). Of the 13 patients who had an upper GI bleed 3 patients had normal platelet counts and the rest had counts below 1 lakh. The average platelet count of patients who experienced an upper GI bleed was 92000 vs. 1.2 lakh in patients without a GI bleed. The bleeding time was prolonged only in 6 patients with thrombocytopenia indicating BT as an insensitive test. 36 patients had a prolonged INR. Among the 13 patients with upper GI bleed 9 had prolonged INR; indicating other factors play a role in GI bleed Conclusions: Many conclusive results regarding the hematological abnormalities in chronic liver disease were obtained with this limited study involving 50 patients with cirrhosis ⇒ 50 % of patients had thrombocytopenia. ⇒ The average platelet count of patients with an upper GI bleed was 92000 compared to 1.2 lakh to those without an upper GI bleed; suggesting other factors such functional platelet defects may play a role as well. These need to be confirmed with platelet functional studies. ⇒ Bleeding time was prolonged only in 12 % of patients with thrombocytopenia indicating BT as an insensitive test of platelet number and function. ⇒ The PT-INR was elevated in 72 % of patients. However only 25 % of patients with a prolonged PT-INR had upper GI bleed indicating other factors such as a rebalanced hemostatic system at work, however this A Study on Hematological Abnormalities in Chronic Liver Isease DOI: 10.9790/0853-1606143844 www.iosrjournals.org 39 | Page needs to be confirmed with more extensive studies. This result underlines the fact that clinical status of the patient and not lab values have to be treated, when correcting coagulopathy in a patient with cirrhosis. From this study we can conclude that various hematological alterations are very common in cirrhosis patients that needs to be identified and corrected early to reduce morbidity and mortality.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信