133例乙肝患者血小板五项参数检测结果的分析和探讨

目的：讨论血小板五项参数结果在乙肝患者的病情发展中的作用。方法133例患者分成乙肝重症肝炎组17例,乙肝肝硬化组40例,乙肝肝癌组15例,HBV表面抗原携带组31例,分别检测血小板五项。结果实验组当中引发难产的原因明显多于对照组,两组间差异具有统计学意义（P〈0.05）。其中包括有胎方位异常、不同组别的实验室检测结果有所差异。结论乙肝患者的血小板五项参数对于患者的病情发展有很大帮助。     

肝硬化肝癌患者血小板分析四项参数及聚集功能的研究

本对50例肝硬化及19例原发性肝癌患血小板计数(PLT)、平均血小板体积(MPV)、血小扳压积(PCT)及血小板分布宽度(PDW)四项参数进行测定，同时检测其聚集功能(PAg)，以进一步分析肝硬化、肝癌患血小板数量及功能的变化，为肝硬化肝癌患血小板功能和出凝血机制的初步判断提供实验室依据。     

原发性肝癌患者放疗前后血小板参数变化及意义

目的观察血小板参数在原发性肝癌患者常规放疗前后的变化,并探讨其临床意义。方法采用全自动血液分析仪检测70例原发性肝癌患者（肝癌组）放疗前后PLT、平均血小板体积（MPV）、血小板分布宽度（PDW）、大血小板比率（P-LCR）和血小板压积（PCT）,观察并比较血小板参数在肝癌患者放疗前后的变化。另选36例健康体检者作对照（对照组）。结果肝癌组PLT、MPV、PCT、P-LCR均较对照组高（P均〈0．05）,而PDW差异无统计学意义（P〉0.05）。放疗后PLT、MPV、PCT较放疗前明显下降（P〈0．05）,P-LCR、PDW无明显变化（P〉0．05）。结论肝癌患者放疗后PLT、MPV、PCT下降明显。检测血小板参数有助了解肝癌放疗患者的骨髓造血情况。     

132例肝病患者血小板4项指标检测结果分析

1 对象与方法1.1 病例 132例肝病患者均为住院病人,其中男11例,女21例,年龄12～69岁,平均34.4岁。诊断标准按1995年5月北京全国病毒性肝炎防治方案(试行)进行,其中急性肝炎17例,重症肝炎6例,慢性肝炎(轻度)22例,慢性肝炎(中度)57例,肝硬化26例,肝癌4例。     

肝硬化患者血小板三项参数的测定及其临床意义

我们应用血液分析仪,测定肝硬化患者血小板计数(PLT)、血小板分布宽度(PDW)和平均血小板体积(MPV),旨在进一步了解肝硬化患者有关血小板参数的改变及其临床意义。 1 材料和方法 1.1 研究对象 肝硬化(包括代偿期和失代偿期)     

重型病毒性肝炎血小板分析4项参数初步观察

采用ＳｙｓｍｅｘＦ－８００型血细胞计数仪对４５例重型病毒性肝炎（重肝）患者进行了血小板４项指标的测定，设急性黄疸型肝炎、慢性活动性肝炎和正常人为对照组。结果显示重肝患者血小板计数、平均血小板体积、血小板压积及血小板分布宽度均显著降低，其中以重肝晚期患者诸项改变最为明显（Ｐ＜０．０５和Ｐ＜０．０１）。提示上述４项指标的测定为重肝血小板功能的初步评价提供了简便的方法。     

老年急性肺部感染患者血小板四项参数检测的临床意义

血小板计数（PLT）是反映血小板生成与衰亡的指标，平均血小板体积（MPV）是反映巨核细胞增生和血小板生成的参数，血小板压积（PCT）是反映血小板总容积的参数，血小板分布宽度（PDW）是反映血小板体积差异程度的参数。我们对老年急性肺部感染患者的血小板参数进行了测定，并探讨其值的变化及在临床上的意义。对象与方法体检正常的健康老年人组100例，男性60例，女性40例，年龄60～81岁；临床确诊急性肺部感染、痰菌阳性者78例，男性52例，女性26例，年龄60～83岁。其中：革兰氏阳性球菌（G）肺感染21例，其中肺炎球菌10例，金黄色葡…     

肾病综合征患者凝血功能检测的结果分析

目的：通过对肾病综合征患者凝血指标的结果分析,探讨其在肾病综合征中的临床意义。方法：采用法国STA-COMPACT全自动凝血分析仪,对43例正常人和59例肾病综合征患者的凝血酶原时间（PT）、活化部分凝血酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）、PLT、血小板压积（PCT）、平均血小板体积（MPV）、血小板分布宽度（PDW）指标的检测与分析,并对结果进行两两比较。结果：肾病综合征组与正常对照组比较,FIB、PLT、MPV、PCT明显升高,APTT明显缩短,均差异有统计学意义（均P〈0.05）,而TT、PT、PDW变化不明显,差异无统计学意义（P〉0.05）。结论：肾病综合征患者存在高凝状态,故凝血功能的检测对肾病综合征病情分析、血栓形成的临床诊断、药物治疗、预后均有重要的参考价值。     

肝硬化患者血小板参数的变化及其临床意义

探讨肝硬化患者出凝血系统的变化及导致出血的原因,采用K4500全自动血球计数仪对60例肝硬化患者进行血小板参数检测,发现肝硬化患者血小板计数(PLT)平均血小板体积(MPV)及血小板压积(PCT),血小板分布宽度(PDW),与对照组相比均有显著性差异(P<0.01和P<0.05),出血组与非出血组比较PLT、PCT、MPV亦有显著差异(P<0.01)。血小板四项参数对肝硬化患者血小板功能及出凝血异常的判断有一定的参考价值,可作为衡量肝硬化出血倾向的重要指标之一。     

肝硬化患者的血小板参数检测及其临床意义

乙型病毒性肝炎后肝硬化的病人血小板减少是众所周知的。由于乙型肝炎病毒(HBV)感染后,可损害骨髓的造血功能和机体的免疫功能,引起不同程度的单核-巨噬细胞系统功能减弱,脾功能亢进,尤其是HBV抑制巨核细胞增殖,在病毒或毒素的作用下会导致血小板超微结构的异常。为了解肝硬化患者血小板的变化情况,     

不同肝功能分级肝硬化患者血小板参数、胃电参数及胃肠激素水平比较

目的比较不同肝功能分级肝硬化患者血小板参数、胃电参数及胃肠激素水平。方法选取2012年2月-2013年1月于岑溪市人民医院进行诊治的48例肝硬化患者作为观察组,同时期体检的48名健康人员作为对照组,将两组人员的血小板参数、胃电参数及胃肠激素水平进行比较,并对观察组中不同Child-Pugh分级者的上述指标进行比较。结果观察组的PLT和PCT均低于对照组,PDW、MPV及P-LCR均高于对照组,餐前及餐后的胃电幅值、胃电频率和正常慢波节律比均低于对照组,餐前及餐后的血清GAS、VIP、MTL均高于对照组,并且Child-Pugh分级高者波动大于分级低者,差异有统计学意义(P均0.05)。结论肝硬化患者血小板参数、胃电参数及胃肠激素存在明显的异常波动,且Child-Pugh分级越高者波动越大。     

营养支持联合美他多辛治疗酒精性肝病患者肝功能和外周血细胞参数的变化

目的 探讨营养支持联合美他多辛治疗酒精性肝病患者对肝功能、红细胞和血小板参数的影响。方法 2015年5月~2017年10月我院诊治的酒精性肝病患者90例,被分为两组,每组45例,分别给予美他多辛片或美他多辛联合营养支持治疗4周,后者为给予35~40 kcat·kg^-1·d^-1的热量。结果 治疗前,两组肝功能指标差异无统计学意义（P>0.05）,治疗结束时,两组血清ALT、GGT和TBIL水平明显降低,ALB明显升高;治疗前,两组凝血功能指标差异无统计学意义（P>0.05）,治疗后两组PT、APTT和TT均明显缩短,FIB显著升高;治疗前,两组红细胞参数和血红蛋白水平差异无统计学意义（P>0.05）,治疗后两组RBC、HGB和HCT均显著上升,RDW和MCV显著下降;治疗前,两组血小板计数（PLT）、血小板平均体积（MPV）和血小板分布宽度（PDW）相比无统计学差异（P>0.05）,治疗后PLT显著上升,MPV和PDW明显降低（P<0.05）,联合组以上变化均显著优于对照组（P<0.05）。结论 营养支持联合美他多辛治疗酒精性肝病患者能够显著改善肝功能、凝血功能、红细胞和血小板参数,提示营养支持治疗可能更重要,需要高度重视。     

早期联合检测血小板膜糖蛋白及血小板参数对脓毒症患者的临床意义

目的:探讨早期联合检测血小板膜糖蛋白表达水平及血小板参数对脓毒血症患者的临床意义。方法:选取40例脓毒症患者,根据急性生理与慢性健康状况(APACHE)Ⅱ评分分为1组(10分)、2组(10~19分)和3组(20分),所有患者均在确诊24 h内采用全自动血细胞仪检测血小板计数(PLT)、大血小板比率(P-LCR)、血小板平均体积(MPV)、血小板分布宽度(PDW);采用流式细胞仪检测血小板膜糖蛋白CD62P、CD63的表达水平。结果:1随着APACHEⅡ评分升高,患者PLT显著下降,P-LCR、MPV、PDW均显著上升(P0.05);2随着APACHEⅡ评分升高,CD62P、CD63表达均上调(P0.05);3Pearson相关性分析显示:随着PLT的下降,血小板MPV、PDW、P-LCR均逐渐上升,血小板MPV、PDW、P-LCR与PLT呈高度负相关性(r=-0.442、-0.395、-0.472,P0.01),PLT与APACHEⅡ评分呈高度负相关(r=-0.602,P0.01);血小板膜糖蛋白CD62P、CD63表达水平与APACHEⅡ评分呈高度正相关(r=0.603、0.619,P0.01);血小板MPV与CD62P、CD63表达水平均呈正相关(r=0.382、0.310,P0.05),血小板P-LCR、PLT、PDW与CD62P、CD63表达水平之间无明显相关性(P0.05)。结论:脓毒症患者早期体内存在血小板高激活状态,根据血小板膜糖蛋白CD62P、CD63及血小板参数可初步判定脓毒症患者病情的变化。     

乙型肝炎后肝硬化患者血小板参数的临床分析

目的 观察血小板参数变化与乙型肝炎后肝硬化的关系并探讨其临床意义。方法 乙型肝炎后肝硬化患者135例（A组）和健康体检者82例（B组）采用全自动血细胞分析仪检PLT、血小板比容（PCT）、平均血小板体积（MPV）、血小板分布宽度（PDW）。A组患者根据有无上消化道出血分为合并上消化道出血组（C组,65例）和无上消化道出血组（D组,70例）,分别比较各组参数情况。结果 A组PLT、PCT均显著低于B组（P均=0.006）,其MPV、PDW均高于B组（P均=0.007）。C组PLT、PCT、MPV、PDW均低于D组（P均〈0.05）。结论 血小板参数的测定对评估肝硬化患者肝功能损害程度、判断有无出血倾向具有重要的指导意义。     

Plasma and platelet serotonin levels in patients with liver cirrhosis

AIM： To analyze the relationship between plasma and platelet serotonin levels and the degree of liver insufficiency. METHODS： The prospective study included 30 patients with liver cirrhosis and 30 healthy controls. The degree of liver failure was assessed according to the Child-Pugh classification. Platelet and platelet poor plasma serotonin levels were determined. RESULTS： The mean plasma serotonin level was higher in liver cirrhosis patients than in healthy subjects （215.0 ±26.1 vs 63.1 ± 18.1 nmol/L; P 〈 0.0001）. The mean platelet serotonin content was not significantly different in patients with liver cirrhosis compared with healthy individuals （4.8 ± 0.6; 4.2± 0.3 nmol/platelet; P 〉 0.05）. Plasma serotonin levels were significantly higher in ChildPugh grade A/B than in grade C patients （246.8 ± 35.0 vs 132.3 ± 30.7 nmol/L; P 〈 0.05）. However, platelet serotonin content was not significantly different between Child-Pugh grade C and grade A/B （4.6 ± 0.7 vs 5.2 ± 0.8 nmol/platelet; P 〉 0.05）. CONCLUSION： Plasma serotonin levels are significantly higher in patients with cirrhosis than in the controls and represent the degree of liver insufficiency. In addition, platelet poor plasma serotonin estimation is a better marker for liver insufficiency than platelet serotonin content.     

Multisciplinary management of patients with liver metastasis from colorectal cancer

Colorectal cancer(CRC) is one of the leading causes of cancer-related death. Surgery, radiotherapy and chemotherapy have been till now the main therapeutic strategies for disease control and improvement of the overall survival. Twenty-five per cent(25%) of CRC patients have clinically detectable liver metastases at the initial diagnosis and approximately 50% develop liver metastases during their disease course. Twentythirty per cent(20%-30%) are CRC patients with metastases confined to the liver. Some years ago various studies showed a curative potential for liver metastases resection. For this reason some authors proposed the conversion of unresectable liver metastases to resectable to achieve cure. Since those results were published, a lot of regimens have been studied for resectability potential. Better results could be obtained by the combination of chemotherapy with targeted drugs, such as anti-VEGF and antiEGFR monoclonal antibodies. However an accurate selection for patients to treat with these regimens and to operate for liver metastases is mandatory to reduce the risk of complications. A multidisciplinary team approach represents the best way for a proper patient management. The team needs to include surgeons, oncologists, diagnostic and interventional radiologists with expertise in hepatobiliary disease, molecular pathologists, and clinical nurse specialists. This review summarizes the most important findings on surgery and systemic treatment of CRC-related liver metastases.     

Studies on tumor-cell-induced platelet aggregation in human lung cancer cell lines

We investigated the ability of human lung cancer cells of different histological subtypes to cause platelet aggregation. Tumor-cell-induced platelet aggregation (TCIPA) was studied in vitro in 13 human lung cancer cell lines [small-cell lung cancer (SCLC), squamous-cell lung cancer, large-cell lung cancer, adenocarcinoma and alveolar-cell lung cancer]. Three tumor cell lines failed to aggregate platelets in plateletrich plasma, whereas platelet aggregation was induced by 12 cell lines when added to washed platelets and minimal amounts of platelet-poor plasma (0.5% v/v). The thrombin antagonist hirudin inhibited TCIPA in non-small-cell lung cancer cell lines (NSCLC). In SCLC, TCIPA was fully abolished only when the ADP scavenger apyrase was added to hirudin. Thus ADP and thrombin generation by these tumor cell lines are responsible for platelet aggregation. The ability to activate platelets independently of coagulation factors VII and X was demonstrated for 8 cell lines. Electronmiicroscopically, direct tumor-cell/platelet contact was found to be the initiating mechanism of TCIPA in SCLC, whereas tumor-cell/platelet contacts in NSCLC could only be observed at the peak of the aggregation curve. Lung cancer cells activate platelets in vitro by generation of thrombin and/or ADP.Abbreviations TCIPA tumor-cell-induced platelet aggregation - SCLC small-cell lung cancer - NSCLC non-small-cell lung cancer     

检测血小板计数及血清纤维连接蛋白对评价肝硬化病情的意义

目的：研究血小板计数及血清纤维连接蛋白对评价肝硬化病情的意义。方法：对63例肝硬化病人按Child-Pugh分级，采用免疫比浊法分别测定其血清Fn水平，并在日本MEK－8118K全自动血液分析仪上对其进行血小板计，与61例健康对照比较。结果：肝硬化组PLT、Fn检测值明显低于正常对照组（P＜0．01），且随着肝硬化病情的加重，PLT、Fn呈渐进性下降差别有显著意义。结论：血小板计数、血清Fn水平测定可作为诊断肝硬化的一种补充指标，对筛查肝硬化有一定价值，并对肝硬化病情评估有重要意义。     

Chemotherapy and resection for gastric cancer with synchronous liver metastases

AIM: To investigate the effect of surgery and chemotherapy for gastric cancer with multiple synchronous liver metastases (GCLM). METHODS: A total of 114 patients were entered in this study, and 20 patients with multiple synchronous liver metastases were eligible. After screening with preoperative chemotherapy, 20 patients underwent curative gastrectomy and hepatectomy for GCLM; 14 underwent major hepatectomy, and the remaining six underwent minor hepatectomy. There were 94 patients without aggressive treatment, and they were in the non-operative group. Two regimens of perioperative chemotherapy were used: S-1 and cisplatin (SP) in 12 patients, and docetaxel, cisplatin and 5-fluorouracil (DCF) in eight patients. These GCLM patients were given preoperative chemotherapy consisting of two courses chemotherapy of SP or DCF regimens. After chemotherapy, gastrectomy and hepatectomy were preformed. Evaluation of patient survival was by follow-up contact using telephone and outpatient records. All patients were assessed every 3 mo during the first year and every 6 mo thereafter. RESULTS: Twenty patients underwent gastrectomy and hepatectomy and completed their perioperative chemotherapy and hepatic arterial infusion before and after surgery. Ninety-four patients had no aggressive treatment of liver metastases because of technical difficulties with resection and severe cardiopulmonary dysfunction. In the surgery group, there was no toxicity greater than grade 3 during the course of chemotherapy. The response rate was 100% according to the Response Evaluation Criteria in Solid Tumors Criteria. For all 114 patients, the overall survival rate was 8.0%, 4.0%, 4.0% and 4.0% at 1, 2, 3 and 4 years, respectively, with a median survival time (MST) of 8.5 mo (range: 0.5-48 mo). For the 20 patients in the surgery group, MST was 22.3 mo (range: 4-48 mo). In the 94 patients without aggressive treatment, MST was 5.5 mo (range: 0.5-21 mo). There was a significant difference between the surgery and unresectable patients (P = 0.000). Thr