肝硬化与慢性再生障碍性贫血患者的血细胞比较研究  

Peripheral blood cell parameters in patients with post-hepatitis B liver cirrhosis and chronic aplastic anemia

作　　者：向治纬[1] 谢会忠[1] 余丽君[2] 

机构地区：[1]新疆医科大学第一附属医院消化内科,新疆乌鲁木齐830054 [2]石河子大学医学院第一附属医院血液科,新疆石河子832008

出　　处：《中国现代医学杂志》2010年第11期1674-1677,1680,共5页China Journal of Modern Medicine

摘　　要：目的比较乙型肝炎后肝硬化失代偿期贫血与慢性再生障碍性贫血的血细胞参数异同点。方法选择石河子人民医院和石河子大学医学院第一附属医院2007年1月～2009年7月诊断为乙肝后肝硬化失代偿期的患者做为肝硬化组(LC);诊断为再生障碍性贫血的患者,诊断标准符合非重型再障作为慢性再障组(CAA),两组用血液全自动血细胞分析仪作全血细胞分析。结果肝硬化组以巨幼细胞性贫血为多,其次是继发性脾功能亢进,最少是缺铁性贫血;肝硬化组与慢性再生障碍性贫血组的Hb、WBC及PLT有不同程度减少,两组差异有显著性(P<0.01),两组血细胞参数比较,LC组Hb、RBC、WBC、PLT、HCT及MCHC均显著高于CAA组,MCV均低于CAA,差异有显著性(P<0.01)。结论乙型肝炎后肝硬化失代偿期血细胞减少以轻度贫血为主,慢性再障以重度贫血为主,两组Hb、RBC、WBC、PLT、HCT、MCV及MCHC差异有显著性,肝硬化贫血红细胞形态以大细胞性贫血为多,巨幼细胞性贫血为主;慢性再障以正常细胞性贫血为主。肝硬化出现铁、叶酸减少,有继发性脾功能亢进,有HBV导致骨髓的抑制;肝、脾及骨髓共同作用的机制可能是LC血三系减少的主要病因。多数的CAA组血细胞参数明显比LC组偏低。[Objective]To compare the differences and similarities of blood cell parameters in patients with de-compensated liver cirrhosis after hepatitis B and in patients with chronic aplastic anaemia （CAA）. [Methods]The patients, who were diagnosed as liver cirrhosis （LC） after hepatitis B without severe aplastic anaemia（NSAA） during January, 2007 and July, 2009 in Shihezi People＇s Hospital and the First Affiliated Hospital of Medical College of Shihezi University, were enrolled in LC group; Those diagnosed as non-severe aplastic anemia were enrolled in CAA group . The blood cells in both groups were analyzed by automatic hematology analyzer. [Results]In LC group, megaloblastic anaemia （MA） appeared most often, the next was portal hypertension, the least was the iron deficient anaemia （IDA）. In both groups, Hb, WBC and PLT decreased in different degree and with significant difference （P 0.05）. Hb, RBC, WBC, PLT, HCT and MCHC were significantly higher while MCV was significantly lower in LC group than in CAA group （P 0.05）.[Conclusion]For cytopenia, light anaemia mainly appears in LC patients, se-vere anaemia mainly in CAA patients. In both groups there are significant differences in Hb, RBC, WBC, PLT, HCT, MCV and MCHC. Regarding red cell configuration, the majority in LC group are macrocytic anaemia and MA, CAA patients mainly have normal cells anaemia. LC patients have decreased iron and folic acid, and the secondary hyper-splenism and bone marrow suppression resulted from HBV. Co-effect of liver, spleen and marrow may be the main reason for decreased Hb, WBC and PLT. Numerous blood cell parameters in CAA patients are significantly lower than those in LC cases.

关 键 词：乙型肝炎后肝硬化失代偿期 慢性再生障碍性贫血 血细胞分析 

分 类 号：R446.11[医药卫生—诊断学]