血小板输注治疗肝硬化的临床疗效观察  

Platelet Transfusion Omproves Liver Function in Patients with Hepatitis Cirrhosis

作　　者：胡尕伟 李荣梓[2] 杨鹏[2] 耿闻男[2] 黄亚琼[2] 

机构地区：[1]解放军68307部队医院 [2]兰州军区总医院

出　　处：《现代生物医学进展》2015年第6期1116-1119,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30770823)

摘　　要：目的:观察血小板灌注治疗对肝硬化患者肝功能的影响。方法:选择10名有血小板减少(血小板计数在50,000至100,000/μl)表现的肝硬化患者(Child-Pugh分级分别为A级或者B级),每周给予10个单位血小板输注治疗,疗程共12周,在给予最后一次治疗后坚持随访9个月。在血小板输注治疗结束后1周、1个月、3个月以及9个月时,应用腹部超声检测腹水、CT观察肝脏肿瘤及肝脏体积并检测患者的肝功能指标,如血清白蛋白、血清胆碱酯酶、谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素以及凝血酶原激活时间。结果:2名患者由于皮肤瘙痒中断血小板输注治疗,2名患者治疗后随访丢失,最后共6名患者的数据纳入研究。在接受完最后一次血小板输注治疗后,6名患者的血小板计数无显著提高。最后一次血小板输注治疗后1个月和3个月复查时,患者的血清白蛋白水平显著升高。治疗后1周,3个月以及9个月时,患者血清胆碱酯酶在均显著增加。结论:尽管血小板输注治疗对一部分患者存在不良反应,但其可显著提高肝硬化患者的一些肝功能指标,可以作为临床治疗肝硬化的新方法深入研究。Objective： To investigate the effect of platelet transfusion on the liver function of patients with cirrhosis. Methods： The study included 10 patients with cirrhosis（Child-Pugh class A or B）, who all presented thrombocytopenia（platelet counts between 50,000 and 100,000/μl）. The subjects received 10 unit of platelet concentrate once a week for 12 weeks. They were followed up for 9 months after the last transfusion. We used abdominal ultrasonography and CT scan to investigate ascites and liver tumer during the process of the trial. The serum albumin, serum cholinesterase, AST, ALT, total bilirubin（T-Bil）, prothrombin time activity were observed t at 1 week, 1 month, 3 month, 9 month after the last transfution. Results： 2 patients discontinued platelet transfusion because of pruritus, and 2 patient were excluded from the analysis for receiving a procedural treatment after 12 platelet transfusion. Thus, the remaining 6 patients were analyzed. The platelet counts did not increase significantly after the last transfusion. Serum albumin was significantly increased at 1 month and 3 months after the last transfusion. Serum cholinesterase improved significantly at 1 week, 3 months and 9 months after the last transfusion. Conclusion： Platelet transfusion could improve some indicators of liver function in patients with cirrhosis, though adverse events related to platelet transfusion were observed in some patients. Platelet increment therapy could be a new strategy for treating cirrhosis.

关 键 词：血小板输注治疗 肝硬化 肝功能 血清白蛋白 血清胆碱酯酶 

分 类 号：R575.2[医药卫生—消化系统]