不同病因肝硬化患者的贫血及红细胞特征

Characteristics of anemia and red blood cells in patients with cirrhosis caused by different etiological factor

目的探讨不同病因所致肝硬化患者的贫血及红细胞特征。方法选择2011年2月至2012年11月在咸宁市中心医院诊治的肝硬化患者232例,其中乙型肝炎肝硬化114例,丙型肝炎肝硬化24例,乙醇性肝硬化50例,胆汁淤积性肝硬化44例。所有患者于入院后测定红细胞、白细胞、血小板、血红蛋白、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)及红细胞体积分布宽度(RDW),并对结果进行统计分析。结果乙型肝炎肝硬化和胆汁淤积性肝硬化患者以正常细胞性贫血为主,丙型肝炎肝硬化和乙醇性肝硬化患者以大细胞性贫血为主。乙型肝炎肝硬化和胆汁淤积性肝硬化患者MCV、MCH、MCHC及RDW与正常细胞性贫血患者比较差异均无统计学意义(P>0.05);丙型肝炎肝硬化和乙醇性肝硬化患者MCV、MCH显著高于正常细胞性贫血患者,差异有统计学意义(P<0.05);丙型肝炎肝硬化和乙醇性肝硬化患者MCHC、RDW与正常细胞性贫血患者比较差异均无统计学意义(P>0.05)。结论不同病因所致肝硬化患者具有不同的贫血类型及红细胞特征,分析肝硬化患者的贫血类型和红细胞特征,可为肝硬化的诊断和治疗提供指导。

Objective To study the characteristics of anemias and red blood cells in patients with cirrhosis caused by different etiological factor. Methods A total of 232 patients with cirrhosis were selected in the Central Hospital of Xianning City from February 2011 to November 2012. Among these patients, 114 cases were hepatitis B cirrhosis ,24 cases were hepatitis C cirrhosis ,50 cases were alcoholic cirrhosis ,44 cases were eholestasis cirrhosis. The red blood cell,white blood cell ,platelet, hemoglobin, mean corpuscular volume （MCV） , mean corpuscular hemoglobin （MCH） , mean corpuscular-hemoglobin concentra- tion（MCHC） and red distribution width（RDW） were detected in all patients after hospitalization,then the results were ana- lyzed statistically. Results The anaemia of the patients with hepatitis B cirrhosis and cholestasis cirrhosis was normoeytic ane- mia mainly, the anaemia of the patients with hepatitis C cirrhosis and alcoholic cirrhosis was macrocytic anemia mainly. There was no significant difference in MCV, MCH, MCHC and RDW among the patients with hepatitis B cirrhosis, alcoholic cirrhosis and normocytic anemia（ P 〉0.05 ）. The MCV and MCH in the patients with hepatitis C cirrhosis and alcoholic cirrhosis were significantly higher than those in the patients with normocytic anemia（ P 〈 0.05 ）. There was no significant difference in MCHC and RDW among the patients with hepatitis C cirrhosis, alcoholic cirrhosis and normocytic anemia（P 〉 0.05 ）. Conclusions The patients caused by different etiological factor have different anemia category and red blood cell characteristics. The analysis of anemia category and red blood cell characteristics can provide guidance for the diagnosis and treatment of cirrhosis.