Leite Luiz Arthur Calheiros, Domingues Ana Lúcia Coutinho, Lopes Edmundo Pessoa, Ferreira Rita de Cássia Dos Santos, Pimenta Adenor de Almeida, da Fonseca Caíque Silveira Martins, Dos Santos Bianka Santana, Lima Vera Lúcia de Menezes
Universidade Federal de Pernambuco - UFPE, Recife, PE, Brazil.
Rev Bras Hematol Hemoter. 2013;35(5):332-6. doi: 10.5581/1516-8484.20130098.
Schistosomiasis is a tropical disease. Patients who develop hepatosplenic schistosomiasis have clinical findings including periportal fibrosis, portal hypertension, cytopenia, splenomegaly and gastrointestinal hemorrhage.
The aim of this study was to analyze the hemostatic and hematologic findings of patients with schistosomiasis and correlate these to the size of the spleen.
Fifty-five adults with hepatosplenic schistosomiasis and 30 healthy subjects were selected through a history of contact with contaminated water, physical examination and ultrasound characteristics such as periportal fibrosis and splenomegaly in the Gastroenterology Service of the Universidade Federal de Pernambuco. Blood samples were collected to determine liver function, blood counts, prothrombin (international normalized ratio), partial thromboplastin time and fibrinogen and D-Dimer levels using the Pentra 120 hematological analyzer (HORIBA/ABX), Density Plus (test photo-optical Trinity Biotech, Ireland) and COBAS analyzer 6000 (Roche). Furthermore, the longitudinal size of the spleen was measured by ultrasound (Acuson X analyzer 150, Siemens). The Student t-test, the Fisher test and Pearson's correlation were used to analyze the results with statistical significance being set for a p-value < 0.05.
The mean age was higher for the Study Group than for the Control Group (54 ± 13.9 vs. 38 ± 12.7 years). The average longitudinal diameter of the spleen was 16.9 cm (Range: 12.3-26.3 cm). Anemia is a common finding in patients with schistosomiasis (36.3%). The mean platelet and leukocyte counts of patients were lower than for the Control Group (p-value < 0.001). Moreover, the international normalized ratio (1.42 vs. 1.04), partial thromboplastin time (37.9 vs. 30.5 seconds) and D-Dimer concentration (393 vs. 86.5 ng/mL) were higher for the Study Group compared to the Control Group.
This study suggests that hematological and hemostatic abnormalities are associated with splenomegaly, hypersplenism and portal hypertension.
血吸虫病是一种热带疾病。患有肝脾型血吸虫病的患者临床表现包括门静脉周围纤维化、门静脉高压、血细胞减少、脾肿大和胃肠道出血。
本研究旨在分析血吸虫病患者的止血和血液学检查结果，并将这些结果与脾脏大小相关联。
通过接触受污染水的病史、体格检查以及伯南布哥联邦大学胃肠病科的门静脉周围纤维化和脾肿大等超声特征，选取了55例肝脾型血吸虫病成人患者和30名健康受试者。采集血样，使用Pentra 120血液分析仪（堀场/ABX）、Density Plus（爱尔兰Trinity Biotech公司的光电检测法）和COBAS 6000分析仪（罗氏）测定肝功能、血细胞计数、凝血酶原（国际标准化比值）、活化部分凝血活酶时间和纤维蛋白原以及D - 二聚体水平。此外，通过超声（西门子Acuson X 分析仪150）测量脾脏的纵向大小。采用Student t检验、Fisher检验和Pearson相关性分析结果，并将p值<0.05设定为具有统计学意义。
研究组的平均年龄高于对照组（54±13.9岁对38±12.7岁）。脾脏的平均纵向直径为16.9厘米（范围：12.3 - 26.3厘米）。贫血是血吸虫病患者的常见表现（36.3%）。患者的平均血小板和白细胞计数低于对照组（p值<0.001）。此外，研究组的国际标准化比值（1.42对1.04）、活化部分凝血活酶时间（37.9秒对30.5秒）和D - 二聚体浓度（393对86.5纳克/毫升）高于对照组。
本研究表明血液学和止血异常与脾肿大、脾功能亢进和门静脉高压相关。
