Baidu
map

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.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2072049, encodeId=278d20e20498b, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Dec 26 12:45:00 CST 2018, time=2018-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711352, encodeId=5ff11e11352ea, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jul 17 11:45:00 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064305, encodeId=88542064305da, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Sep 06 23:45:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480174, encodeId=1f0214801e496, content=<a href='/topic/show?id=4892890598d' target=_blank style='color:#2F92EE;'>#血小板计数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89059, encryptionId=4892890598d, topicName=血小板计数)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ee9b7619292, createdName=12498877m100暂无昵称, createdTime=Thu Jan 25 11:45:00 CST 2018, time=2018-01-25, status=1, ipAttribution=)]
    2018-12-26 许安
  2. [GetPortalCommentsPageByObjectIdResponse(id=2072049, encodeId=278d20e20498b, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Dec 26 12:45:00 CST 2018, time=2018-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711352, encodeId=5ff11e11352ea, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jul 17 11:45:00 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064305, encodeId=88542064305da, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Sep 06 23:45:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480174, encodeId=1f0214801e496, content=<a href='/topic/show?id=4892890598d' target=_blank style='color:#2F92EE;'>#血小板计数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89059, encryptionId=4892890598d, topicName=血小板计数)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ee9b7619292, createdName=12498877m100暂无昵称, createdTime=Thu Jan 25 11:45:00 CST 2018, time=2018-01-25, status=1, ipAttribution=)]
    2018-07-17 zhaojie88
  3. [GetPortalCommentsPageByObjectIdResponse(id=2072049, encodeId=278d20e20498b, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Dec 26 12:45:00 CST 2018, time=2018-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711352, encodeId=5ff11e11352ea, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jul 17 11:45:00 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064305, encodeId=88542064305da, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Sep 06 23:45:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480174, encodeId=1f0214801e496, content=<a href='/topic/show?id=4892890598d' target=_blank style='color:#2F92EE;'>#血小板计数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89059, encryptionId=4892890598d, topicName=血小板计数)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ee9b7619292, createdName=12498877m100暂无昵称, createdTime=Thu Jan 25 11:45:00 CST 2018, time=2018-01-25, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2072049, encodeId=278d20e20498b, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Dec 26 12:45:00 CST 2018, time=2018-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711352, encodeId=5ff11e11352ea, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jul 17 11:45:00 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064305, encodeId=88542064305da, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Sep 06 23:45:00 CST 2018, time=2018-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480174, encodeId=1f0214801e496, content=<a href='/topic/show?id=4892890598d' target=_blank style='color:#2F92EE;'>#血小板计数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89059, encryptionId=4892890598d, topicName=血小板计数)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ee9b7619292, createdName=12498877m100暂无昵称, createdTime=Thu Jan 25 11:45:00 CST 2018, time=2018-01-25, status=1, ipAttribution=)]

相关资讯

Cell:血小板:身体的清道夫!

德国慕尼黑Ludwig-Maximilians大学(LMU)医学研究人员进行的一项新研究,扩展了被称为血小板的最小血细胞所执行的任务清单:在感染的部位,主动迁移的血小板能够清理细菌,将这些细菌形成聚集物以供吞噬细胞处置。

Sci Rep:血小板/淋巴细胞比例在泌尿肿瘤中的预后意义

在之前的研究中,血小板与淋巴细胞比例(PLR)和泌尿肿瘤生存之间的关系的研究结果并不一致。因此,最近,有研究人员进行了元分析来评估患有泌尿肿瘤的病人中PLR的预后意义。研究人员在PubMed、Embase和Web of Science数据库中进行了文献搜索,搜索的文献的时间到2017年7月,研究质量利用 Newcastle-Ottawa Scale评分系统进行分析。为了评估PLR和总生存(OS)和

Nature子刊:找到干细胞靶向修复损伤心脏的新方法

导读:心肌梗死可引起心脏的大面积损伤,逐步发展为心力衰竭。干细胞是促进梗死心脏心肌再生的有效方法,但是缺乏治疗靶向性。美国北卡州立大学/北卡教堂山分校的最新一项研究表明,可以利用血小板修饰干细胞靶向修复损伤心脏。这一创新研究由美国北卡州立大学/北卡教堂山分校的程柯教授带领团队完成。他们研发出血小板纳米颗粒,用于修饰心脏干细胞,指引干细胞靶向受损心脏,并停留在损伤区域,从而增强干细胞的修复能力。相关

Blood:急性血小板减少后,新产生的幼稚血小板常出现GPVI信号缺陷。

血管损伤的部位,暴露的内皮下胶原通过与血小板表面的免疫受体酪氨酸激活模体(ITAM)-偶联糖蛋白(GP)VI相互作用,,从而激活血小板和血栓形成。血小板是由巨核细胞(MKs)的细胞质衍生而来,巨噬细胞将巨大的血小板前体延伸到骨髓(BM)窦,进而脱落入血,最终在血液中形成正常大小的血小板并成熟。在胶原蛋白富集的BM环境中,MKs活化以及形成血小板前体的过程受抑制的机制仍不明确。本研究中,研究人员发现

Hepatology:急性肝衰竭导致出血并发症

尽管有出血倾向,临床上ALF患者显著的出血并不常见。出血并发症是严重系统性炎症的标志,而非凝血功能障碍,预示预后不良

JACC:血小板在外周动脉疾病发生中的机制研究

外周动脉疾病(PAD)是动脉粥样硬化血栓形成的一种弥漫性病变,对患者心血管有潜在风险。血小板虽然是动脉粥样硬化血栓形成的关键因子,但其在PAD中的发病机制尚未阐明。本研究有症状的PAD患者和正常对照进行血小板活性、mRNA和效应器活性的检测。血小板RNA测序结果显示粒细胞相关蛋白(MRP)-14 mRNA在PAD患者中有明显的上调,循环中火化的血小板富含MRP-14蛋白,它可以促进黏附介质(P-选

Baidu
map
Baidu
map
Baidu
map