血栓弹力图和血小板抗体检测在血小板输注中的应用价值  

Application value of thromboelastography and platelet antibody detection in platelet transfusion

作　　者：李贤见 王长本 朱兴春 LI Xianjian;WANG Changben;ZHU Xingchun(Department of Clinical Laboratory,Kaizhou District People′s Hospital,Chongqing 405499,China)

机构地区：[1]开州区人民医院检验科,重庆405499

出　　处：《现代医药卫生》2019年第6期841-843,847,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨血栓弹力图(TEG)、血小板抗体检测在血小板输注中的临床价值。方法选取2013年1月至2018年3月该院输注血小板患者210例,分为观察组(120例)和随机组(90例),比较2组血小板输注率、输注效果,并分析观察组血小板抗体产生情况,以及影响血小板输注效果的因素。结果 2组血小板输注率比较,差异有统计学意义(P<0.05)。男女之间血小板抗体阳性率比较,差异无统计学意义(P>0.05);有妊娠史患者血小板抗体阳性率大于无妊娠史患者,差异有统计学意义(P<0.05);不同疾病、血小板输注次数患者血小板抗体阳性率比较,差异均有统计学意义(P<0.05)。观察组血小板输注有效率高于随机组,差异有统计学意义(P<0.05)。输血史、有无抗体、有无配型后输注是影响血小板输注效果的独立危险因素。结论在血小板输注前进行TEG和血小板抗体检测,可避免血液资源浪费,降低血小板输注次数和血小板抗体阳性率。同时,根据血小板抗体检测结果进行血小板配型后输注,能提高输注效果。Objective To explore the clinical value of thromboelastography (TEG) and platelet antibody detection in platelet transfusion. Methods 210 platelet transfusion patients in the hospital from January 2013 to March 2018 were divided into observation group(120 cases) and random group(90 cases).The platelet transfusion rate and effect were compared between the two groups.The platelet antibody production in observation group and the factors affecting platelet transfusion effect were analyzed. Results There was significant difference in platelet transfusion rate between the two groups( P <0.05).There was no significant difference in the positive rate of platelet antibody between men and women(P>0.05);the positive rate of platelet antibody in patients with pregnancy history was higher than that in patients without pregnancy history( P <0.05);the positive rate of platelet antibody in patients with different diseases and times of platelet transfusion was significantly different( P <0.05).The effective rate of platelet transfusion in the observation group was higher than that in the random group( P <0.05).The number of transfusions,whether there were antibodies or not,and whether transfusions after matching were independent risk factors affecting the effect of platelet transfusion. Conclusion Thromboelastography and platelet antibody detection before platelet transfusion can avoid wasting blood resources and reduce the number of platelet transfusion and the positive rate of platelet antibody.At the same time,transfusion after platelet matching according to the results of platelet antibody test can improve the transfusion effect.

关 键 词：血栓弹力描记术 血小板/免疫学 血小板输注 治疗结果 

分 类 号：R457.1[医药卫生—治疗学]