Abstract
This study investigates peripheral cytopenias in patients with splenomegaly caused by nonalcoholic cirrhotic portal hypertension. Data from 330 splenomegaly cases caused by nonalcoholic cirrhotic portal hypertension were collected and analyzed using univariate and multivariate analysis. The cytopenias were scored and graded according to the F value of the multiple linear regression equation. Based on the severity of thrombocytopenia, cytopenia was graded as mild, moderate, or severe, and determined by a score of <2 points, 2–3 points, and >3 points. 30 % of the patients had monolineage cytopenias, 35.8 % had bilineage cytopenias, and 34.2 % had trilineage cytopenias. All patients were treated surgically. In the univariate analysis, the severity of erythropenia was different in the surgical outcome when compared to the intra-group (P < 0.05). In the multivariate analysis, thrombocytopenia was different in the surgical outcomes when compared with leukopenia and erythropenia (P < 0.05). There was a significant difference in surgical outcomes between the three grades (mild, moderate, and severe) of cytopenia (P < 0.05). Peripheral cytopenias have a significant impact on the clinical outcomes. The more severe the cytopenias, the worse the surgical outcomes are. Thrombocytopenia is a major factor influencing surgical outcomes. The thrombocytopenia-based three-level grading of cytopenias provides a basis for analyzing individual cases, planning treatment, and assessing prognosis in clinical practice.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Yang, Z., & Qiu, F. Z. (2003). Prognosis of portal hypertension. Journal of Abdominal Surgery, 16, 68–70.
Lv, Y. F., Gong, X. G., Li, X. Q., et al. (2008). Changes in peripheral blood cells in portal hypertension complicated by splenomegaly. Chinese Journal of Digestive Surgery, 7, 281–283.
Karasu, Z., Gurakar, A., Kerwin, B., Hulagu, S., Jazzar, A., McFadden, R., et al. (2001). Effect of transjuqular intrahepatic portosystemic shunt on thrombocytopenia associated with cirrhosis. Digestive Diseases and Sciences, 46, 449–456.
Fadi, N. B., Carlos, J. T., Kevin, D., et al. (2000). Prevalence of peripheral blood cytopenias (hypersplenism) in patients with nonalcoholic liver disease. Am College of Gastroeterology, 95, 2937–2939.
Yan, F., Li, W., Gao, J., Zeng, Y. M., Guo, Y. W., Zhang, F. R., et al. (2006). cDNA micoarray–based screening of differentially expressed genes in macrophages in the spleen of patients with portal Hypertension and hypersplenism. Journal of Southern Medical University, 26, 1548–1551.
Yun-fu, L., Xin-qiu, L., Xian-he, X., et al. (2009). Portal hypertension splenomegaly is not always associated with hematocytopenia. Journal of US-China Medical Science, 6, 28–30.
Djordjević, J., Svorcan, P., Vrinić, D., & Dapcević, B. (2010). Splenomegaly and thrombocytopenia in patients with liver cirrhosis. Vojnosanitetski Pregled, 67, 166–169.
Zhang, J. Y., Wang, Y., Zhang, J., Ding, S. G., Zhou, L. Y., & Lin, S. R. (2010). Risk factors associated with failure from endoscopic therapy in acute non-variceal upper gastrointestinal bleeding. Journal of Beijing Medical University, 42, 703–707.
Sarode, R. (2012). How do I transfuse platelets (PLTs) to reverse anti-PLT drug effect? Transfusion, 52, 695–701.
Cui, Y., Hei, F., Long, C., Feng, Z., Zhao, J., Yan, F., et al. (2009). Perioperative monitoring of thrombo elastograph on hemostasis and therapy for cyanotic infants undergoing complex cardiac surgery. Artificial Organs, 33, 909–914.
Lv, Y. F., Li, X. Q., Huang, W. W., et al. (2007). Changes in peripheral blood cells in patients with hypersplenism due to portal hypertension. Chinese Journal of General Surgery, 22, 702.
Matsuura, T., Hayashida, M., Saeki, I., & Taguchi, T. (2010). The risk factors of persistent thrombocytopenia and splenomegaly after liver transplantation. Pediatric Surgery International, 26, 1007–1010.
Johansson, P. I., & Stensballe, J. (2010). Hemostatic resuscitation for massive bleeding: the paradigm of plasma and platelets–a review of the current literature. Transfusion, 50, 701–710.
Shontz, R., Karuparthy, V., Temple, R., & Brennan, T. J. (2009). Prevalence and risk factors predisposing to coagulopathy in patients receiving epidural analgesia for hepatic surgery. Regional Anesthesia and Pain Medicine, 34, 308–311.
Shaz, B. H., Dente, C. J., Nicholas, J., MacLeod, J. B., Young, A. N., Easley, K., et al. (2010). Increased number of coagulation products in relationship to red blood cell products transfused improves mortality in trauma patients. Transfusion, 50, 493–500.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lv, Y., Han, X., Gong, X. et al. Grading of Peripheral Cytopenias Caused by Nonalcoholic Cirrhotic Portal Hypertension and Its Clinical Significance. Cell Biochem Biophys 71, 1141–1145 (2015). https://doi.org/10.1007/s12013-014-0321-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12013-014-0321-x