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目的探讨肝硬化患者红细胞参数变化特点及其与肝功能损害程度的相关性及不同程度肝损伤患者外周血网织红细胞的差异。方法采用ADVIA120型全自动血细胞分析仪检测肝硬化患者、慢性肝炎患者及正常健康人群的血细胞参数及网织红细胞数,并计算相应的RPI,对比分析三组患者血细胞参数及网织红细胞数的差异。结果肝硬化组血红蛋白(HGB)、红细胞(RBC)、血细胞比容(HCT)显著低于慢性肝炎组及对照组,而红细胞分布宽度(RDW)显著高于慢性肝炎及对照组,差异有统计学意义(P<0.05)。而平均红细胞体积(MCV)、血红蛋白平均浓度(MCH)、红细胞平均血红蛋白浓度(MCHC)差异无统计学意义(P>0.05)。根据肝硬化临床表现将其分为代偿期及失代偿期,其中失代偿期组血细胞参数变化大于代偿期组,随着肝硬化程度的加重,HGB、RBC、HCT的变化也随之加重。与对照组相比,肝硬化及肝炎患者RPI显著升高,但肝硬化组升幅最大,差异有统计学意义(P<0.05)。结论血红细胞参数的变化与肝硬化患者肝功能损害程度有关,可作为临床区分代偿期及失偿期的指标。肝硬化及慢性肝炎患者RPI值的升高提示患者骨髓红细胞生长旺盛,提示患者可能出现早期贫血。
Objective To investigate the characteristics of erythrocyte parameters in cirrhotic patients and its correlation with the severity of liver dysfunction and the differences of peripheral blood reticulocytes in patients with liver injury. Methods The blood cell parameters and reticulocyte count of cirrhotic patients, patients with chronic hepatitis and normal healthy people were detected by ADVIA120 automatic hematology analyzer, and the corresponding RPI was calculated. The differences of blood cell parameters and reticulocyte count between the three groups were analyzed . Results The levels of hemoglobin (HGB), erythrocytes (RBC) and hematocrit (HCT) in cirrhosis group were significantly lower than those in chronic hepatitis group and control group, but the RDW was significantly higher than that in chronic hepatitis group and control group Significance (P <0.05). There was no significant difference in average MCV, MCH and MCHC (P> 0.05). According to the clinical manifestations of cirrhosis, it was divided into compensatory period and decompensated period. The changes of blood cell parameters in decompensated period were more than those in compensated period. With the increase of cirrhosis, the change of HGB, RBC and HCT Aggravating Compared with the control group, patients with cirrhosis and hepatitis were significantly higher RPI, but the largest increase in cirrhosis group, the difference was statistically significant (P <0.05). Conclusion The changes of erythrocyte parameters are related to the degree of liver dysfunction in patients with cirrhosis, which can be used as an index to distinguish between decompensation and compensation. Patients with cirrhosis and chronic hepatitis RPI value of elevated bone marrow erythrocytes prompted vigorous growth, suggesting that patients may have early anemia.