Objective To summarize the cause of cirrhosis patients with rapid decrease of platelet level. Methods Eight posthepatitic cirrhosis patients were involved in our study and their liver function indexes, prothrombin activity, antiplatelet antibody and bone marrow biopsy results were retrospectively analyzed. Results Eight cirrhosis patients with developing thrombocytopenia were out of proportion to their liver diseases, and they were diagnosed as immune thrombocytopenia based on positive anti-platelet antibody and exclusion of severe infection, disseminated intravascular coagulation, aplastic anemia, lymphoma, thrombotic thrombocytopenic purpura and so on. All patients' platelet obviously increased after treatment with immunoglobulin and corticosteroids. Conclusion Immune thrombocytopenia should be considered coexistence in posthepatitic cirrhosis patients when the platelets decreased markedly in a short-term.%目的总结肝炎肝硬化患者血小板短期内急剧下降的原因.方法 回顾分析8例肝炎肝硬化合并进行性血小板下降的患者肝功能指标、凝血指标、免疫学指标及骨髓涂片结果,分析导致血小板下降的原因.结果 8例患者血小板进行性下降与其肝硬化严重程度不成比例,并能够除外严重感染、弥漫性血管内凝血、再生障碍性贫血、淋巴瘤、血栓性血小板减少性紫癜等血液系统疾病,抗血小板抗体阳性,诊断为免疫性血小板减少症,应用丙种球蛋白、激素治疗后血小板明显升高.结论 肝炎肝硬化患者血小板短期内明显下降时,应考虑合并存在免疫性血小板减少症.
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