在肝硬化患者中,网状血小板的增加和过度活化,特别是那些结果不佳的患者
Alberto Zanetto1, Serena Toffanin2, Elena Campello3
1Gastroenterology and Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Padova, Italy.
概括
网状血小板 (RePLT) 在肝硬化患者中升高和过度活化. 缺乏补偿的患者中较高的RePLT水平表明预后较差,有助于风险分层.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 血液学 血液学 血液学
- 临床化学 临床化学
背景情况:
- 网状血小板 (RePLT) 是在增加血小板周转期间释放的不成熟血小板.
- 肝硬化与血小板数量和功能的改变有关.
研究的目的:
- 在肝硬化患者中描述RePLT.
- 评估 RePLT 与肝脏衰竭或死亡之间的关联.
主要方法:
- 对45名肝硬化患者 (没有HCC) 和20名健康对照进行前性研究.
- 通过细胞度计和免疫光显微镜评估RePLT.
- 在6个月内跟踪患者,以检查肝脏衰竭和ACLF.
主要成果:
- 与对照人群相比,肝硬化患者的RePLT水平显著更高 (0.82%对比0.05%) 和过度活化.
- RePLT水平与查尔德-普格评分,MELD或C反应蛋白没有相关性.
- 在失补偿患者 (CP B/C) 中,较高的RePLT预测了进一步失补偿/ACLF的进展 (p < 0.01).
- 一个RePLT比例>2%确定了高风险患者,具有94%的灵敏度和73%的特异性 (AUROC 0.818).
结论:
- 网状血小板在肝硬化时增加并过度激活.
- 在非补偿性肝硬化中,高RePLT水平与不良结果有关,可以作为预后标志物.
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