Hematological abnormalities in liver cirrhosis  

作　　者：Oscar Manuel Fierro-Angulo JoséAlberto González-Regueiro Ariana Pereira-García Astrid Ruiz-Margáin Fernando Solis-Huerta Ricardo Ulises Macías-Rodríguez 

机构地区：[1]Department of Gastroenterology,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,Mexico 14080,Mexico [2]Department of Hematology,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,Mexico 14080,Mexico

出　　处：《World Journal of Hepatology》2024年第9期1229-1244,共16页世界肝病学杂志（英文）

摘　　要：Hematological abnormalities are common in cirrhosis and are associated with various pathophysiological mechanisms.Studies have documented a prevalence of thrombocytopenia,leukopenia,and anemia in patients with compensated cirrhosis of 77.9%,23.5%,and 21.1%,respectively.These abnormalities carry significant clinical implications,including considerations for invasive procedures,infection risk,bleeding risk,and prognosis.Previously,cirrhosis was believed to predispose patients to bleeding due to alterations observed in classical coagula-tion tests such as prothrombin time,partial thromboplastin time,international normalized ratio,and thrombocytopenia.However,this understanding has evol-ved,and cirrhosis patients are now also acknowledged as being at a high risk for thrombotic events.Hemostasis in cirrhosis patients presents a complex pheno-type,with procoagulant and anticoagulant abnormalities offsetting each other.This multifactorial phenomenon is inadequately reflected by routine laboratory tests.Thrombotic complications are more prevalent in decompensated cirrhosis and may correlate with disease severity.Bleeding is primarily associated with portal hypertension,endothelial dysfunction,mechanical vessel injury,dissem-inated intravascular coagulation,endotoxemia,and renal injury.This review comprehensively outlines hematologic index abnormalities,mechanisms of hemostasis,coagulation,and fibrinolysis abnormalities,limitations of laboratory testing,and clinical manifestations of bleeding and thrombosis in patients with liver cirrhosis.

关 键 词：Cirrhosis Anemia LEUKOPENIA THROMBOCYTOPENIA COAGULOPATHY Bleeding THROMBOSIS 

分 类 号：R575.2[医药卫生—消化系统]