Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism
机构：[1]Peking University People’s Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China[2]Departments of Hematology, Beijing Hospital, National Center of Gerontology, Beijing 100005, China[3]Department of Hematology, Beijing Tongren Hospital, Beijing 100730, China临床科室血液内科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[4]Department of Hematology, Sichuan University West China Medical Center, Chengdu 610041, China[5]Department of Hematology, Shandong Provincial Hospital, Qingdao 266003, China[6]Peking University, People’s Hospital, Institute of Hepatic Diseases, Beijing 100044, China
The aim of the present study was to investigate the relationship between hypothyroidism and thrombocytopenia in hepatitis B-related compensatory liver cirrhosis and to determine whether treatment with levothyroxine and prednisone is superior in a multicenter, open-label, observational study in China. In total, 125 consecutive hepatitis B-related compensated liver cirrhosis patients with severe thrombocytopenia accompanied by hypothyroidism were included. The patients were divided into four groups according to treatment strategy: a control group (n=29), a prednisone group (n=25), a levothyroxine group (n=32) and a prednisone plus levothyroxine group (n=39). Severe thrombocytopenia was more prevalent in hepatitis B-associated compensatory liver cirrhosis patients with hypothyroidism than in euthyroid patients (29.6% vs. 14.7%, P < 0.05). Combination treatment with prednisone and levothyroxine decreased the risk of bleeding and improved platelet recovery compared to control treatment and treatment with either prednisone or levothyroxine alone. The platelet count before therapy, serum thyroid stimulating hormone and combination treatment with prednisone and levothyroxine were associated with bleeding events. Therefore, the present study suggests that hypothyroidism is associated with severe thrombocytopenia in hepatitis B-associated compensatory liver cirrhosis. Treatment with prednisone plus levothyroxine may present a novel approach in these patients.
基金：
National
Natural Science Foundation of China (81470343, 81670116), National
Natural Science Foundation for Young Scholars of China (81600132), Key
Program of National Natural Science Foundation of China (81730004),
Beijing Natural Science Foundation (7171013), Beijing Municipal Science
and Technology Commission (Z171100001017084), the National Key Research
and Development Program of China (2017YFA0105503) and the
Foundation for Innovative Research Groups of the National Natural Science
Foundation of China (81621001).
第一作者机构：[1]Peking University People’s Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Xue Jing,Feng Ru,Fu Haixia,et al.Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism[J].SCIENCE CHINA-LIFE SCIENCES.2018,61(8):924-933.doi:10.1007/s11427-017-9250-1.
APA：
Xue, Jing,Feng, Ru,Fu, Haixia,Jiang, Qian,Jiang, Hao...&Zhang, Xiaohui.(2018).Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism.SCIENCE CHINA-LIFE SCIENCES,61,(8)
MLA：
Xue, Jing,et al."Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism".SCIENCE CHINA-LIFE SCIENCES 61..8(2018):924-933
