Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.
Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Dig Dis. 2023;41(4):632-640. doi: 10.1159/000530473. Epub 2023 Apr 5.
Anemia is a common manifestation of chronic liver diseases. It is a predictor of severe disease, a high risk of complications, and poor outcomes in various liver diseases. However, it remains unclear whether anemia serves as a similar indicator in patients with Wilson disease (WD). Therefore, this study aimed to investigate the relationship between anemia and severity, hepatic complications, and the progression of WD.
Medical data were collected retrospectively from January 1, 2016, to December 31, 2020. Univariate and multivariate analyses were carried out to investigate the relationship between anemia and liver-associated disease severity, hepatic complications, and the progression of WD.
A total of 288 WD patients (48 with and 240 without anemia) were enrolled in the study. Multivariate linear regression revealed that WD patients with anemia had significantly higher levels of bilirubin, alanine transaminase, prothrombin time, international normalized ratio, type Ⅳ collagen, and hyaluronic acid and significantly lower levels of albumin, total cholesterol, and high-density lipoprotein-cholesterol (all p < 0.05). Multivariate logistic regression showed that anemia was a risk factor for gastric varices and ascites (all p < 0.05). Fully adjusted Cox regression revealed that anemia was an independent risk factor for advanced Child-Pugh classification (p = 0.034).
Anemia was common in WD patients and was associated with greater disease severity, a higher risk of hepatic complications, and a faster progression.
贫血是慢性肝病的常见表现。它是疾病严重程度的预测因素，也是各种肝脏疾病发生并发症和不良预后的高危因素。然而，贫血是否在威尔逊病（WD）患者中作为类似的指标尚不清楚。因此，本研究旨在探讨贫血与 WD 严重程度、肝并发症和疾病进展之间的关系。
回顾性收集 2016 年 1 月 1 日至 2020 年 12 月 31 日的医疗数据。采用单因素和多因素分析方法探讨贫血与肝脏相关疾病严重程度、肝并发症和 WD 进展之间的关系。
共纳入 288 例 WD 患者（48 例伴贫血，240 例无贫血）。多因素线性回归显示，伴贫血的 WD 患者胆红素、丙氨酸转氨酶、凝血酶原时间、国际标准化比值、Ⅳ型胶原和透明质酸水平显著升高，白蛋白、总胆固醇和高密度脂蛋白胆固醇水平显著降低（均 p < 0.05）。多因素 logistic 回归显示，贫血是胃静脉曲张和腹水的危险因素（均 p < 0.05）。完全调整的 Cox 回归显示，贫血是晚期 Child-Pugh 分级的独立危险因素（p = 0.034）。
贫血在 WD 患者中较为常见，与疾病严重程度增加、发生肝并发症的风险增加和疾病进展加快有关。
