What diseases are commonly associated with prolonged bleeding time

Prolonged bleeding time is common in diseases such as thrombocytopenic purpura, hemophilia, vitamin K deficiency, cirrhosis, and aplastic anemia. It is mainly related to factors such as abnormal platelet count or function, lack of coagulation factors, and abnormal blood vessel walls.

1. Platelet abnormalities:

Thrombocytopenic purpura is a typical representative, manifested as skin bruising, nasal bleeding, etc. Patients with immune thrombocytopenia often have a peripheral blood platelet count below 50 × 10 ⁹/L. Bone marrow aspiration shows impaired megakaryocyte maturation. Some patients may have autoimmune diseases such as splenic hyperfunction or systemic lupus erythematosus.

2. Coagulation factor deficiency:

Hemophilia patients suffer from coagulation dysfunction due to genetic coagulation factor VIII or IX deficiency. Typical manifestations include joint cavity bleeding and muscle hematoma. Acquired coagulation factor deficiency can be seen in patients with severe liver disease or long-term use of warfarin, and laboratory tests show significantly prolonged activated partial thromboplastin time.

3. Vitamin K deficiency:

Neonatal hemorrhage is caused by insufficient synthesis of vitamin K-dependent coagulation factors. Adult deficiency is commonly seen in biliary obstruction, long-term use of antibiotics, or malabsorption syndrome. Prolonged prothrombin time is an important diagnostic criterion, and supplementing with vitamin K can rapidly improve coagulation function.

4. Liver disease:

Cirrhotic patients have decreased ability to synthesize coagulation factors in the liver, which may be accompanied by splenic hyperfunction leading to increased platelet destruction. In clinical practice, besides bleeding, it is often accompanied by symptoms such as jaundice and ascites. The coagulation function test showed a decrease in the activity of multiple coagulation factors.

5. Bone marrow hematopoietic disorders:

Patients with aplastic anemia have decreased whole blood cells and low bone marrow proliferation. In addition to bleeding from the skin and mucous membranes, it is often accompanied by symptoms of infection and anemia. Peripheral blood tests showed a decrease in the absolute value of reticulocytes, and bone marrow biopsy revealed the replacement of hematopoietic tissue with adipose tissue.

Avoid vigorous exercise and external injuries in daily life, and use a soft bristled toothbrush to reduce the risk of gum bleeding. Diet should ensure sufficient intake of protein and iron, such as lean meat, animal liver, etc. Dark green vegetables are rich in vitamin K, which has an auxiliary effect on improving coagulation function. Regularly monitor blood routine and coagulation function indicators. If there is continuous bleeding or hematoma, seek medical attention immediately. Special populations such as pregnant women and newborns should follow medical advice for preventive supplementation of vitamin K.