丙型肝炎病毒感染相关的血小板减少症。

Thrombocytopenia associated with hepatitis C viral infection.

作者信息

Nagamine T, Ohtuka T, Takehara K, Arai T, Takagi H, Mori M

机构信息

First Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan.

出版信息

J Hepatol. 1996 Feb;24(2):135-40. doi: 10.1016/s0168-8278(96)80021-3.

DOI:10.1016/s0168-8278(96)80021-3

PMID:8907565

Abstract

BACKGROUND/AIMS: We investigated whether chronic hepatitis C infection is associated with thrombocytopenia.

METHODS/RESULTS: Thrombocytopenia (<15 x 10(4) platelets/mu l) was diagnosed in 151 of 368 patients (41.0%) with chronic hepatitis C, a significantly higher proportion than that observed in patients with chronic hepatitis B (18.9%, p < 0.01). Elevated titers of platelet-associated immunoglobulin G were observed in 88.1% of patients with chronic hepatitis C and in 47.1% of patients with chronic hepatitis B. Platelet-associated immunoglobulin G titers were significantly higher in patients with chronic hepatitis C (87.3 +/- 10.1 ng/10(7) cells) vs. those with chronic hepatitis B (30.3 +/- 6.4) or the control subjects (p < 0.01). There was a significant negative correlation between platelet-associated immunoglobulin G titers and platelet counts in both chronic hepatitis C and B cases. Platelet-associated immunoglobulin G titers were significantly higher in patients with type C cirrhosis than in those with type B cirrhosis. Interestingly, HCV-RNA was detected by RT-PCR in the platelets from 11 of 14 patients with hepatitis C virus.

CONCLUSIONS

These data indicate that chronic infection with hepatitis C virus may produce a significant autoimmune reaction to platelets, leading to thrombocytopenia.

摘要

背景/目的：我们研究了慢性丙型肝炎感染是否与血小板减少有关。

方法/结果：368例慢性丙型肝炎患者中有151例（41.0%）被诊断为血小板减少（血小板计数<15×10⁴/μl），这一比例显著高于慢性乙型肝炎患者（18.9%，p<0.01）。88.1%的慢性丙型肝炎患者和47.1%的慢性乙型肝炎患者血小板相关免疫球蛋白G滴度升高。慢性丙型肝炎患者的血小板相关免疫球蛋白G滴度（87.3±10.1 ng/10⁷细胞）显著高于慢性乙型肝炎患者（30.3±6.4）或对照组（p<0.01）。慢性丙型肝炎和乙型肝炎病例中，血小板相关免疫球蛋白G滴度与血小板计数之间均存在显著负相关。丙型肝硬化患者的血小板相关免疫球蛋白G滴度显著高于乙型肝硬化患者。有趣的是，14例丙型肝炎病毒感染患者中有11例的血小板通过逆转录聚合酶链反应检测到丙型肝炎病毒核糖核酸。