Abbasi Amanullah, Butt Nazish, Bhutto Abdul Rab, Munir S M
Ward-7, Jinnah Postgraduate Medical Centre, Karachi.
J Coll Physicians Surg Pak. 2010 Jun;20(6):369-72.
To determine the severity of thrombocytopenia in different grades of esophageal varices.
Cross-sectional analytical study.
Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from January to December 2008.
Subjects were eligible if they had a diagnosis of cirrhosis. Patient with advanced cirrhosis (Child-Pugh class C), human immunodeficiency virus (HIV) infection, hepatocellular carcinoma, portal vein thrombosis, parenteral drug addiction, current alcohol abuse and previous or current treatment with b-blockers, diuretics and other vasoactive drugs were excluded from the study. All patients under went upper gastrointestinal endoscopy after consent. On the basis of platelet count patients were divided into four groups. Group I with platelets (2) 20000/mm(3), Group II with values of 21000- 50000/mm(3), Group III with count of 51000-99000/mm(3) and Group IV with count of 100000-150000/mm(3). Correlation of severity of thrombocytopenia with the grading of esophageal varices was assessed using Spearman's correlation with r-values of 0.01 considered significant.
One hundred and two patients with thrombocytopenia and esophageal varices were included in the study. There were 62 (60.8%) males and 40 (39.2%) females. The mean age of onset of the disease in these patients was 49.49 + or - 14.3 years with range of 11-85 years. Major causes of cirrhosis were hepatitis C (n=79, 77.5%), hepatitis B (n=12, 11.8%), mixed hepatitis B and C infection (n=8, 7.8%) and Wilson's disease (n=3,2.9%). Seven patients had esophageal grade I, 24 had grade II, 35 had grade III, and 36 had grade IV. Gastric varices were detected in 2 patients. Portal hypertensive gastropathy were detected in 87 patients. There was an inverse correlation of platelet count with grading of esophageal varices (r=-0.321, p < 0.001).
The severity of thrombocytopenia increased as the grading of esophageal varices increased. Thrombocyte count was significantly and inversely correlated with the grade of esophageal varices.
确定不同等级食管静脉曲张患者血小板减少症的严重程度。
横断面分析研究。
2008年1月至12月于卡拉奇真纳研究生医学中心第三医疗单元7号病房。
符合肝硬化诊断标准的患者纳入研究。晚期肝硬化（Child-Pugh C级）、人类免疫缺陷病毒（HIV）感染、肝细胞癌、门静脉血栓形成、注射吸毒、当前酗酒以及既往或当前接受β受体阻滞剂、利尿剂和其他血管活性药物治疗的患者被排除在研究之外。所有患者在获得同意后接受上消化道内镜检查。根据血小板计数将患者分为四组。第一组血小板计数<20000/mm³，第二组为21000 - 50000/mm³，第三组为51000 - 99000/mm³，第四组为100000 - 150000/mm³。采用Spearman相关性分析评估血小板减少症严重程度与食管静脉曲张分级的相关性，r值<0.01被认为具有显著性。
102例血小板减少症合并食管静脉曲张患者纳入研究。其中男性62例（60.8%），女性40例（39.2%）。这些患者疾病的平均发病年龄为49.49±14.3岁，范围为11 - 85岁。肝硬化的主要病因是丙型肝炎（n = 79，77.5%）、乙型肝炎（n = 12，11.8%）、乙型和丙型肝炎混合感染（n = 8，7.8%）以及威尔逊病（n = 3，2.9%）。7例患者为I级食管静脉曲张，24例为II级，35例为III级，36例为IV级。2例患者检测到胃静脉曲张。87例患者检测到门静脉高压性胃病。血小板计数与食管静脉曲张分级呈负相关（r = -0.321，p < 0.001）。
食管静脉曲张分级越高，血小板减少症的严重程度越高。血小板计数与食管静脉曲张分级呈显著负相关。
