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肝硬化中的血液学异常:一篇叙述性综述。

Hematological Abnormalities in Cirrhosis: A Narrative Review.

作者信息

Lingas Elvina C

机构信息

Internal Medicine, Presbyterian Hospital, Albuquerque, USA.

出版信息

Cureus. 2023 May 19;15(5):e39239. doi: 10.7759/cureus.39239. eCollection 2023 May.

Abstract

Liver cirrhosis remains a major public health issue. Liver fibrosis leading to cirrhosis is the terminal stage of various chronic liver diseases. Inflammatory cytokines are involved in the pathogenesis. Patients with cirrhosis often have hematological abnormalities, such as anemia and thrombocytopenia, which have multifactorial etiologies. Anemia in cirrhosis could be related to bleeding leading to iron deficiency anemia or other nutritional anemia such as vitamin B12 and folate deficiency. The pathophysiology of thrombocytopenia in liver cirrhosis has been postulated to range from splenic sequestration to bone marrow suppression from toxic agents, such as alcohol. It often complicates management due to the risk of bleeding with severely low platelets. This review aimed to highlight pathogenesis of liver cirrhosis, hematological abnormalities in liver cirrhosis, and their clinical significance.

摘要

肝硬化仍然是一个主要的公共卫生问题。导致肝硬化的肝纤维化是各种慢性肝病的终末期。炎症细胞因子参与其发病机制。肝硬化患者常出现血液学异常,如贫血和血小板减少,其病因是多因素的。肝硬化中的贫血可能与出血导致缺铁性贫血或其他营养性贫血有关,如维生素B12和叶酸缺乏。肝硬化中血小板减少的病理生理学被认为从脾扣押到诸如酒精等有毒物质导致的骨髓抑制不等。由于血小板严重减少会有出血风险,这常常使治疗复杂化。本综述旨在强调肝硬化的发病机制、肝硬化中的血液学异常及其临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38ca/10277171/05e245b8e500/cureus-0015-00000039239-i01.jpg

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