Causes of Thrombocytopenia in Chronic Hepatitis C Viral Infection
Causes of Thrombocytopenia in Chronic Hepatitis C Viral Infection
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DOI：
10.1177/1076029611429124
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发表时间：
2012-05-01
影响因子：
2.9
通讯作者：
Ozaki, Yukio
中科院分区：
文献类型：
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作者：
Osada, Makoto;Kaneko, Makoto;Ozaki, Yukio
对89例慢性丙型肝炎病毒（HCV）感染患者（包括50例慢性肝炎（CH），18例肝硬化（LC），21例LC合并肝癌（LC + HCC））血小板减少的相关因素进行回顾性分析。血小板计数随肝病分期的进展而降低。多元回归分析显示，脾肿大和血管性血友病因子（vWF）是血小板减少的解释变量。脾肿大似乎是最负责任的因素，尽管有相当数量的血小板减少病例没有脾肿大，这表明其他因素也可能是负责任的。vWF水平与血小板计数呈负相关。可溶性血栓调节蛋白是内皮功能障碍的标志物，随着肝纤维化的进展而增加。与vWF呈正相关，与血小板计数呈负相关。我们目前的研究结果表明，血管内皮功能障碍也参与慢性HCV感染血小板减少症。
We retrospectively studied 89 patients with chronic hepatitis C virus (HCV) infection, including 50 chronic hepatitis (CH) cases, 18 liver cirrhosis (LC) cases, and 21 LC with hepatocellular carcinoma (LC + HCC) cases, with regard to various factors related with thrombocytopenia. The platelet count decreased with the stage advancement of liver diseases. Multiple regression analysis revealed that splenomegaly and von Willebrand factor (vWF) were explanatory variables that correlated with thrombocytopenia. Splenomegaly appears to be the most responsible factor, although there are a considerable number of thrombocytopenic cases without splenomegaly, suggesting other factors may also be responsible. The vWF level is inversely correlated with the platelet count. Soluble thrombomodulin, a marker of endothelial dysfunction, increases with the advancement of liver fibrosis. It is positively correlated with vWF and inversely with the platelet count. Our present results imply that vascular endothelial dysfunction is also involved in thrombocytopenia during chronic HCV infection.