Influencing factors for peripheral neutropenia in patients with hepatolenticular degeneration after splenectomy
Objective To investigate the clinical features of neutropenia after splenectomy in patients with hepatolen-ticular degeneration,also known as Wilson's disease(WD),and related influencing factors.Methods The patients with WD who were hospitalized and underwent splenectomy from January 2018 to March 2023 were enrolled as subjects.The patients with an absolute neutrophil count of<1.7×109/L at 1 year after splenectomy were enrolled as observation group,and those with an absolute neutrophil count of≥1.7×109/L were enrolled as control group.The two groups were compared in terms of the change in routine blood test results at 1 year after splenectomy,as well as the indicators such as general information,preopera-tive myelogram data,preoperative Child-Pugh score,preoperative spleen size,surgical procedures,and postoperative labora-tory markers,and the influencing factors for the reduction in neutrophil count were analyzed.Results A total of 61 patients were included.At 1 year after splenectomy,both groups had significant increases in white blood cell count,neutrophil count,red blood cell count,and platelet count and a significant reduction in the percentage of neutrophils(P<0.05).After surgery,39.34%(24/61)of the patients still had a neutrophil count lower than the normal level.Before surgery,compared with the con-trol group,the observation group had significantly higher Child-Pugh score,total bilirubin(TBIL),aspartate aminotransferase,and prothrombin time and a significantly lower level of albumin(ALB)(P<0.05),and there was also a significant difference in the proportion of patients with ascites between the two groups(P<0.05).The multivariate analysis showed that preoperative Child-Pugh score,TBIL,and ALB were independent influencing factors for neutropenia.Conclusion Splenectomy cannot completely correct neutrophil level in WD patients,which may be associated with the degree of liver damage.
万方数据
维普
