肝病相关血小板减少症临床管理中国专家共识

Chinese expert consensus on the clinical management of liver disease-associated thrombocytopenia syndrome

肝病相关血小板减少症指肝病或肝病治疗所致的血小板减少症,发生率与肝病病程及严重程度相关。血小板减少症对肝病患者临床结局的直接影响是出血风险增加,间接影响涉及因潜在出血风险导致的治疗延迟或终止。肝病相关血小板减少症的病理生理机制涉及血小板生成减少、分布异常、破坏或消耗增加等。目前,针对不同机制的治疗策略包括促血小板生成药物、手术、免疫抑制药物及输注血小板等,但临床应用有待进一步规范。为提升我国肝病相关血小板减少症在诊断、分型及治疗方案合理选择等方面的临床管理水平,国家感染性疾病临床医学研究中心组织专家,参考相关领域最新循证医学证据,讨论制定了本共识。

Liver disease-associated thrombocytopenia syndrome refers to thrombocytopenia caused by liver disease or the treatment of liver disease,and its incidence rate is related to the duration and severity of liver disease.The direct effect of thrombocytopenia on clinical outcomes is an increased risk of bleeding in patients with liver disease,whereas the indirect effect involves delay or termination of treatment due to the potential risk of bleeding.Liver disease-associated thrombocytopenia pathophysiological mechanisms involve decreased platelet production,abnormal distribution,destruction,or increased consumption.Presently,treatment strategies targeting different mechanisms include platelet-stimulating drugs,surgery,immunosuppressive drugs,and platelet transfusion,but the clinical application needs to be standardized further.The National Clinical Research Center for Infectious Diseases organized experts to discuss and formulate consensus with reference to the latest evidence-based medical evidence in the field so as to improve the clinical management level of liver disease-associated thrombocytopenia syndrome in China in terms of diagnosis,typing,and reasonable selection of treatment schemes.