| 원저 : 비대상성 알콜성 및 바이러스성 간경변증사이의 혈소판 감소증 비교 ( Thrombocytopenia between Decompensated Alcoholic and Viral Liver Cirrhosis ) |
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| Thrombocytopenia between Decompensated Alcoholic and Viral Liver Cirrhosis |
| Eun Sil Koo, M.D., Byung Ik Kim, M.D., Si Young Kim, M.D., Yong Kyun Cho, M.D.
Chang Sub Kim, M.D., Chang Young Park, M.D., Chong Il Sohn, M.D., Woo Kyu Jeon, M.D.
Eul Soon Jung, M.D. Dong Kug Kum, M.D.*, Young Rae Lee, M.D.†
Hwa Young Lee, M.D.‡ , Sang Jong Lee, M.D.‡ |
| Department of Internal Medicine, Clinical Pathology*, Radiology†
Kangbuk Samsung Hosp., Sungkyunkwan University, School of Medicine Cha Hosp.,
Pochon University, College of Medicine‡, Seoul, Korea |
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| ABSTRACT |
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Background/Aims
Thrombocytopenia is frequently found among patients with chronic liver disease, and its mechanism, especially among patients with decompensated liver cirrhosis had not been established. Therefore to elucidate the mechanism of thrombocytopenia, the relationship between thrombocytopenia and severity of hepatic dysfunction, splenomegaly was measured. We measured the peripheral blood components with splenic volume obtained from a computerized tomography of decompensated liver cirrhosis patients. Methods: We studied 103 patients who had been diagnosed with decompensated liver cirrhosis with esophageal varices and ascites from January 1982 to August 1999. We checked their counts of platelets, albumin, bilirubin, splenic volume, degree of esophageal varices, hepatic encephalopathy and ascites by retrograde methods. Results: In viral liver cirrhosis, thrombocytopenia and splenomegaly correlated well with disease severity but they didn't in alcoholic cirrhosis. Of special note, the platelet count was significantly lower and the splenic volume was larger in the Child C of viral cirrhosis patients group than in the alcoholic group(p<0.05). Conclusion: When we compared decompensated alcoholic with viral liver cirrhosis patients, the degrees of thrombocytopenia and splenomegaly were much less in the former group. The factors for this phenomena are Splenic Pooling theory, Platelet-associated IgG, Thrombopoietin and Toxic Marrow. We suggest that splenomegaly is an important factor among these, but the mechanisms involved in the pathogenesis of this hematologic phenomena are not completely understood. Especially in alcoholic liver cirrhosis, many other factors may be involved, including the direct effect of alcohol to bone marrow, so further studies will be needed to establish whether a causal relationship exists.(Korean J Hepatol 2000;6:215-222) |
| KeyWords:
Decompensated Liver cirrhosis/Viral/Alcoholic, Thrombocytopenia, Splenomegaly |
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