Serum Thrombopoietin In Chronic Liver Disease: Relation To Platelet Count And Liver Function

Objective: To investigate the relationship between serum thrombopoietin(TPO) and platelets count with liver function in patients with chronic liver disease(CLD) and find the valuable experimental and theoretical proof for the pathogenesy and treatment of thrombocytopenia related to CLD. Methods: The study included 42 patients with liver cirrhosis(LC),15 with chronic hepatitis(CH) and 11 healthy controls(C). Serum thrombopoietin levels were measured by radioimmunoassay(RIA). Additionally, circulating platelet counts(PLT),serum albumin levels(ALB), prothrombin time(PT) and prothrombin activity(PTA) were determined. Results: 1,Mean serum thrombopoietin level (70.89±17.81pg/mL) in the chronic hepatitis group was higher than that of the healthy group (62.56±11.46pg/mL),but no difference;however,serum thrombopoietin levels in patients with liver cirrhosis (81.34±19.85pg/mL) were higher than patients with chronic hepatitis and controls (P<0.01 for controls). Cirrhotic patients had increased prothrombin time(15.74±3.91s) and decreased platelet counts( 110.02±96.69×10~9/L ) ,serum albumin level (30.25±9.24g/L) and prothrombin activity(0.70±0.28) when compared to control groups(P<0.05). 2,In patients with liver cirrhosis, serum thrombopoietin levels were found to be increased as the disease progressed(74.82±13.55pg/mL in patients at Child-Pugh stage A, 83.22±24.80pg/mL in patients at stage B and 102.28±14.70pg/mL in patients at stage C). Platelets count decreased significantly with Child-Pugh stage(P<0.01). 3,Serum TPO levels were negatively correlated with serum albumin and prothrombin activity(P<0.05 and P<0.01 respectively ) ,and positively correlated with prothrombin time and Pugh score(P<0.01 and P<0.05 respectively). Platelet counts did not correlate with serum TPO levels and Pugh score(P>0.05). 4,In patients with liver cirrhosis, 28 with thrombocytopenia(66.7%), serum TPO levels were similar in non-thrombocytopenia group and thrombocytopenia group(80.85±26.23pg/ml vs 81.59±16.34pg/ml,P>0.05), platelets count was significantly decreased(P<0.01). 5,serum TPO levels and platelets count had no significantly difference between posthepatitic cirrhosis and other disease etiology induced cirrhosis(P>0.05). 6,In patients with liver cirrhosis, platelets counts were significantly increased in splenectomy group compared to non-splenectomy group(P>0.05), while serum TPO levels did not differ(P>0.05). Conclusions: The findings reveal that serum TPO levels are normal in patients with chronic hepatitis, but in patients with liver cirrhosis, serum TPO levels increase, as degree of cirrhosis progresses. Serum TPO levels don't change while platelets counts significantly increase after splenectomy suggest that serum TPO level may not be directly associated with thrombocytopenia in patients with chronic hepatitis and liver cirrhosis,hypersplenism are predominant thrombocytopenic mechanisms.