目的:探讨慢性乙型肝炎患者血小板减少的影响因素.方法:测定200例慢性乙型肝炎患者血小板计数、血小板体积、脾脏大小及HBV DNA水平,按肝损程度、脾脏大小、HBV DNA水平分组进行统计学分析.结果:与健康时照组相比,慢性乙型肝炎患者血小板计数减少(P＜0.01),血小板体积增大(P＜0.05);与肝损轻中度组、正常脾组相比,重度肝损组、脾脏肿大组血小板计数均显著减少(均P＜0.01),而不同血清病毒负载量分组间无显著差异(P＞0.05).结论:肝功能损害和脾肿大是血小板减少的重要影响因素,持续肝功能稳定对提升血小板意义重大.

[1] 中华医学会传染病与寄生虫病学分会, 中华医学会肝病学分会. 病毒性肝炎防治方案. 中华肝脏病杂志2000(6)
[2] 李琴, 孙桂珍, 王宝恩. 肝硬化患者血小板计数与血小板生成素及脾脏指数间的关系. 中华肝脏病杂志2004(4)
[3] GIANNINI E G. Thrombocytopenia in chronic liver disease and pharmacologic treatment options, 2006(8)
[4] ZELDIS J B, FARRAYE F A, STEINHERG H N. In vitro hepatitis B virus suppression of erythropoiesis is dependent on the multiplicity of infection and is reversible with anti-HBs antibodies. 1988(4). doi:10.1002/hep.1840080409
[5] OKUMOTO K, SAITO T, ONODERA M. Serum levels of stem cell factor and thrombopoietin are markedly decreased in fulminant hepatic failure patients with a poor prognosis. 2007(8). doi:10.1111/j.1440-1746.2006.04497.x
[6] SAN JO A, SATOI J, OHNISHI A. Role of elevated platelet-associated immunoglobulin G and hypersplenism in thrombocytopenia of chronic liver diseases. 2003(6). doi:10.1046/j.1440-1746.2003.03026.x