Lu Yao, Zhang Yan-li, Shen Ge, Zhang Lu, Wang Lin, Qiu Guo-hua, Wu Yun-zhong, Yang Min, Li Ming-hui
Hepatology Centre, Beijing Ditan Hospital, Capital Medical University, Beijing 100011, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2011 Aug;25(4):283-5.
To study the clinical features, outcomes and treatments of viral hepatitis combined with aplastic anemia.
25 cases diagnosed as viral hepatits combined with aplastic anemia in Beijing Ditan Hsopital between April 2004 and September 2009 were retrospectively analyzed. In this group of patients aplastic anemia was finally diagnosed by bone marrow aspiration. We collected clinical data of these patients, including a history of liver disease, drug allergies, hospital medication history, laboratory data, and then performed descriptive analysis.
25 patients with viral hepatitis were diagnosed as complicated with aplastic anemia by histopathological data. Among these patients, 17 were male and 8 were women. Viral hepatitis included: chronic hepatitis B (12 cases), chronic hepatitis C (4 cases), acute hepatits E (1 case), hepatitis caused by CMV infection (1 case), and unclassified hepatitis (7 cases). Among these patients, 7 were diagnosed as severe hepatits. Considering previous history, only 3 patients had history of short term interferon therapy before hospitalization, and the remaining patients did not use drug that affects blood system. Treatments were as followings: using colony stimulating factor in 6 patients, gamma globulin in 9 patients, glucocorticoids in 3 patients, erythropoietin in 1 patient, only oral drug to raise erythrocytes in 2 patients, red blood cells transfusion in 6 patients, platelets transfusion in 2 patients. As for clinical outcomes, 20 patients acquired improved condition and were dicharged, 3 patients were discharged voluntarily and 2 patients died of severe hepatits combined with other complications.
Main treatments of viral hepatitis combined with aplastic anemia were to treat primary hepatopathy and nucleoside analogue-based antiviral therapy, to provide symptomatic and supportive treatment for blood diseases. Blood diseases would recover simultaneously while liver disease was improved, and the prognosis was good.
研究病毒性肝炎合并再生障碍性贫血的临床特征、转归及治疗方法。
回顾性分析2004年4月至2009年9月在北京地坛医院确诊为病毒性肝炎合并再生障碍性贫血的25例患者。该组患者最终经骨髓穿刺确诊为再生障碍性贫血。收集这些患者的临床资料，包括肝脏疾病史、药物过敏史、住院用药史、实验室检查数据，然后进行描述性分析。
25例病毒性肝炎患者经组织病理学数据确诊合并再生障碍性贫血。其中男性17例，女性8例。病毒性肝炎包括：慢性乙型肝炎（12例）、慢性丙型肝炎（4例）、急性戊型肝炎（1例）、巨细胞病毒感染所致肝炎（1例）、未分类肝炎（7例）。其中7例被诊断为重型肝炎。考虑既往史，仅3例患者在住院前有短期干扰素治疗史，其余患者未使用过影响血液系统的药物。治疗方法如下：6例患者使用集落刺激因子，9例患者使用丙种球蛋白，3例患者使用糖皮质激素，1例患者使用促红细胞生成素，2例患者仅口服升红细胞药物，6例患者输注红细胞，2例患者输注血小板。至于临床转归，20例患者病情好转出院，3例患者自动出院，2例患者死于重型肝炎合并其他并发症。
病毒性肝炎合并再生障碍性贫血的主要治疗方法是治疗原发性肝病及核苷类似物抗病毒治疗，对血液系统疾病给予对症及支持治疗。随着肝病好转，血液系统疾病会同时恢复，预后良好。
