论文部分内容阅读
目的:观察血小板灌注治疗对肝硬化患者肝功能的影响。方法:选择10名有血小板减少(血小板计数在50,000至100,000/μl)表现的肝硬化患者(Child-Pugh分级分别为A级或者B级),每周给予10个单位血小板输注治疗,疗程共12周,在给予最后一次治疗后坚持随访9个月。在血小板输注治疗结束后1周、1个月、3个月以及9个月时,应用腹部超声检测腹水、CT观察肝脏肿瘤及肝脏体积并检测患者的肝功能指标,如血清白蛋白、血清胆碱酯酶、谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素以及凝血酶原激活时间。结果:2名患者由于皮肤瘙痒中断血小板输注治疗,2名患者治疗后随访丢失,最后共6名患者的数据纳入研究。在接受完最后一次血小板输注治疗后,6名患者的血小板计数无显著提高。最后一次血小板输注治疗后1个月和3个月复查时,患者的血清白蛋白水平显著升高。治疗后1周,3个月以及9个月时,患者血清胆碱酯酶在均显著增加。结论:尽管血小板输注治疗对一部分患者存在不良反应,但其可显著提高肝硬化患者的一些肝功能指标,可以作为临床治疗肝硬化的新方法深入研究。
Objective: To observe the effect of platelet perfusion on liver function in cirrhotic patients. METHODS: Ten patients with cirrhosis (Child-Pugh class A or B, respectively) with thrombocytopenia (platelet count 50,000 to 100,000 / μl) were enrolled. Ten units of platelet transfusion were given per week Twelve weeks, up to 9 months after the last treatment was given. Abdominal ascites was detected by abdominal ultrasonography at 1 week, 1 month, 3 months and 9 months after the end of platelet transfusion. The liver tumor and liver volume were observed by CT and the liver function indexes such as serum albumin, serum Cholinesterase, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and prothrombin time of activation. Results: Two patients discontinued platelet transfusion due to itchy pruritus, and two patients lost follow-up after treatment. The data of the last six patients were included in the study. Six patients had no significant increase in platelet count after receiving the last platelet transfusion. Serum albumin levels were significantly elevated at 1 and 3 months after the last platelet transfusion. Serum cholinesterase was significantly increased at 1 week, 3 months and 9 months after treatment. CONCLUSION: Although platelet transfusion therapy has adverse reactions to some patients, it can significantly improve some liver function indexes in cirrhotic patients and may be used as a new method for clinical treatment of cirrhosis.