Hematological abnormalities in chronic liver disease and their association with severity and types of chronic liver disease

Veena Melwani, M. Tomar, Anshuli Trivedi
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Abstract

This study aimed to assess the hematological abnormalities in CLD patients and to study the association of hematological abnormalities with type and severity of CLD. This study was conducted as a facility based cross-sectional study at tertiary care centre on confirmed cases of chronic liver disease. Detailed clinical history along with clinical examination findings were recorded. All patients were then subjected to investigations. Mean age of patients with CLD was 48.8±16.9 years and majority of patients were males (76%). Anemia was observed in 71% cases with CLD whereas leukocytopenia and thrombocytopenia were noted in 21% and 56% cases respectively. Mean MCV, MCH, serum bilirubin and iron were significantly higher in cases with alcoholic liver disease whereas TIBC was significantly lower in ALD cases as compared to NALD cases (p<0.05). Mean hemoglobin, platelet levels, MCV, albumin and iron levels were significantly lower in cases with severe liver disease (Child Pugh Class C). However, serum bilirubin, prothrombin time and TIBC levels increased significantly with increase in severity of CLD (p<0.05). Hematological abnormalities particularly normocytic normochromic anemia and thrombocytopenia are common in cases with CLD, which might affect the prognosis of patients with CLD. Assessing the severity and type of anaemia is a useful tool for early initiation of the treatment in patients of CLD for reducing the morbidity and mortality. Early detection and treatment of haematological changes can prevent complications and reduce the mortality in CLD patients.
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慢性肝病的血液学异常及其与慢性肝病严重程度和类型的关系
本研究旨在评估慢性肝病患者的血液学异常,并研究血液学异常与慢性肝病类型和严重程度的关系。这项研究是在三级医疗中心对确诊的慢性肝病病例进行的一项基于设施的横断面研究。研究人员记录了详细的临床病史和临床检查结果。然后对所有患者进行检查。慢性肝病患者的平均年龄为(48.8±16.9)岁,大多数患者为男性(76%)。71%的CLD患者出现贫血,21%的患者出现白细胞减少,56%的患者出现血小板减少。酒精性肝病病例的平均 MCV、MCH、血清胆红素和铁明显高于非酒精性肝病病例,而 ALD 病例的 TIBC 则明显低于非酒精性肝病病例(P<0.05)。严重肝病(Child Pugh C 级)病例的平均血红蛋白、血小板水平、MCV、白蛋白和铁水平明显较低。然而,血清胆红素、凝血酶原时间和 TIBC 水平随着 CLD 严重程度的增加而显著上升(P<0.05)。血液学异常,尤其是正常血细胞正常色素性贫血和血小板减少症在 CLD 病例中很常见,这可能会影响 CLD 患者的预后。评估贫血的严重程度和类型是对慢性阻塞性肺病患者进行早期治疗以降低发病率和死亡率的有效工具。及早发现和治疗血液学变化可预防并发症,降低慢性阻塞性肺病患者的死亡率。
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