严重肝病使用血浆致贫血176例临床分析

目的分析晚期肝病患者并发非急性出血性贫血的临床资料和实验室检查结果,探讨其可能原因和机制。方法收集2000年1月至2009年12月共280例晚期肝病合并非急性出血性贫血的住院患者的临床资料,仔细询问病史、体格检查和记录有关的实验室检查结果及临床的治疗情况,分析外周血的形态学特征、骨髓的表现、贫血发生的的可能原因。结果发现晚期肝病患者积极输血浆后出现明显贫血,不输注或输注少量血浆的患者则不明显,两者比较有显著性差异(P<0.01)。结论晚期肝病患者在治疗时频繁血浆输注出现明显的溶血性贫血。这类病人溶血表现不典型,而大部分患者Coomb's试验阴性,有时甚至仅仅表现为Hb的进行性下降。

Objective To analyze the reasons of non-bleeding anemia occurred in patients with end-stage liver disease,and investigate the mechanism of the anemia to find the proper way to improve this condition.Methods We collected clinical data from 280 cases hospitalized During 2000.1～2009.12 with end-stage liver disease,including history report,physical examination,related lab tests and therapeutic methods of the patients.To explore the probable reasons,mechanism of anemia during treatment process,we investigated some factors and analyzed morphological characteristics of blood cells in marrow and peripheral blood.Results In the group 86.4%of the non-bleeding anemia which occurred in the treatment process were related to the regular infusion of the plasma,and the other group without infusion of plasma was only 22.1%（P0.01）.Conclusion The reason of most of the non-bleeding anemia patients were related to the plasma infusion.The clinic manifestation of the hemolysis could be negative,which sometimes be discovered only by the persist descent of the hemoglobin concentration.Most of the cases have a negative result of Coomb＇s test.