Yu Hang, Yu Hongli, Sun Yao, Wang Fu-Sheng, Lu Yinying
Senior Department of Hematology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
Comprehensive Liver Cancer Center, The Fifth Medical Center of PLA General Hospital, Beijing, China.
Hepatol Int. 2025 Feb;19(1):70-86. doi: 10.1007/s12072-024-10755-6. Epub 2025 Feb 5.
Hepatopathy-related thrombocytopenia refers to a reduction in platelet count caused by liver disease or its treatment. The incidence of this condition is correlated with the duration and severity of liver disease. The direct impact of thrombocytopenia on the clinical outcome of patients with liver disease is an increased risk of bleeding. In addition, the indirect effect involves delays or discontinuation of treatment due to the potential risk of bleeding. The pathophysiological mechanisms of hepatopathy-related thrombocytopenia include reduced platelet production, abnormal distribution, increased destruction or consumption, and so on. Current treatment strategies targeting different mechanisms include thrombopoietic agents, surgery, immunosuppressants, and platelet transfusion. However, their clinical application lacks standardization. The National Clinical Research Center for Infectious Diseases organized experts to discuss and develop this consensus to enhance the clinical management level of hepatopathy-related thrombocytopenia in China. The experts focused on aspects of diagnosis, classification, and choosing the best treatment plans based on the most recent research in the field.
肝病相关性血小板减少症是指由肝脏疾病或其治疗引起的血小板计数减少。这种情况的发生率与肝脏疾病的持续时间和严重程度相关。血小板减少症对肝病患者临床结局的直接影响是出血风险增加。此外,间接影响包括由于潜在的出血风险导致治疗延迟或中断。肝病相关性血小板减少症的病理生理机制包括血小板生成减少、分布异常、破坏或消耗增加等。目前针对不同机制的治疗策略包括促血小板生成药物、手术、免疫抑制剂和血小板输注。然而,它们的临床应用缺乏标准化。国家传染病临床研究中心组织专家进行讨论并制定本共识,以提高我国肝病相关性血小板减少症的临床管理水平。专家们基于该领域的最新研究,重点关注诊断、分类以及选择最佳治疗方案等方面。