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学科主题: 临床医学
题名:
Immunosuppressive treatment combined with nucleoside analog is superior to nucleoside analog only in the treatment of severe thrombocytopenia in patients with cirrhosis associated with hepatitis B in China: A multicenter, observational study
作者: Zhang, Xiao Hui1; Feng, Ru2; Xu, Lan Ping1; Jiang, Qian1; Jiang, Hao1; Fu, Hai Xia1; Liu, Hui2; Niu, Ting3; Wang, Xin4; Hu, Jian Da5; Jiang, Ming6; Wang, Zhao7; Wang, Jing Wen8; Ma, Hui9; Xie, Yan Di9; Zhu, Xiao Lu1; Wang, Hao9; Wei, Lai9; Huang, Xiao-Jun1
关键词: Cirrhosis ; cyclosporine ; hepatitis B ; prednisone ; thrombocytopenia
刊名: PLATELETS
发表日期: 2015
DOI: 10.3109/09537104.2014.979339
卷: 26, 期:7, 页:672-679
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cell Biology ; Hematology
研究领域[WOS]: Cell Biology ; Hematology
关键词[WOS]: CHRONIC LIVER-DISEASE ; VIRUS HBV REACTIVATION ; CYCLOSPORINE-A ; LAPAROSCOPIC SPLENECTOMY ; IMMUNE THROMBOCYTOPENIA ; PLATELET TRANSFUSION ; CULTURED-HEPATOCYTES ; PORTAL-HYPERTENSION ; VIRAL-HEPATITIS ; THERAPY
英文摘要:

No effective treatment has been identified for patients of liver cirrhosis (LC) associated with hepatitis B virus (HBV) and severe thrombocytopenia. We aimed to explore the effectiveness and safety of low-dose prednisone or cyclosporine A (CsA) combined with nucleoside analog (NA) in patients with severe thrombocytopenia associated with HBV-related LC. We included 145 consecutive compensated HBV-associated LC patients with severe thrombocytopenia between 1 January 2006 and 31 December 2013. We divided the patients into three groups by treatment strategy, including NA only (n = 57), NA plus prednisone (n = 46), and NA plus CsA (n = 42). We analyzed the platelet counts, bleeding events, liver function, replication of HBV, and outcomes in each group. At all time points during this observation, the platelet counts in prednisone or CsA group were higher than those in the NA only group. There are significant differences in the cumulative rates of bleeding events among the three groups. The platelet counts and treatment were factors associated with bleeding events in multivariate analysis. The differences in HBV-DNA negative rates, HBV-DNA elevated rates, normal serum alanine transaminase rates, serum alanine transaminase elevated more than two times the baseline rates, and HBeAg seropositive conversion ratio among the groups did not reach statistical significance. The adverse events in our study were, in general, mild and balanced among the three treatment groups. Treatment with low-dose prednisone or CsA plus NA could elevate the platelet counts and reduce the risk of bleeding events in HBV LC with severe thrombocytopenia.

语种: 英语
所属项目编号: 2012BAI38B03 ; 81270643 ; 7112139 ; 7132194 ; 20120001110026
项目资助者: National Key Technology Support Program ; National Natural Science Foundation of China ; Natural Science Foundation of Beijing ; Dr disciplines in colleges and universities special research fund
WOS记录号: WOS:000360546300011
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/49972
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: 1.Peking Univ, Peoples Hosp, Inst Hematol, Beijing 100044, Peoples R China
2.Beijing Hosp, Minist Hlth, Dept Hematol, Beijing, Peoples R China
3.Sichuan Univ, West China Hosp, Dept Hematol, Chengdu 610064, Peoples R China
4.Shandong Prov Hosp, Dept Hematol, Qingdao, Peoples R China
5.Fujian Med Univ, Union Hosp, Dept Hematol, Fuzhou, Peoples R China
6.Xinjiang Med Univ, Affiliated Hosp 1, Dept Hematol, Urumqi, Peoples R China
7.Beijing Friendship Hosp, Dept Hematol, Beijing, Peoples R China
8.Beijing Tongren Hosp, Dept Hematol, Beijing, Peoples R China
9.Peking Univ, Peoples Hosp, Inst Hepat Dis, Beijing 100044, Peoples R China

Recommended Citation:
Zhang, Xiao Hui,Feng, Ru,Xu, Lan Ping,et al. Immunosuppressive treatment combined with nucleoside analog is superior to nucleoside analog only in the treatment of severe thrombocytopenia in patients with cirrhosis associated with hepatitis B in China: A multicenter, observational study[J]. PLATELETS,2015,26(7):672-679.
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