99例急性淋巴细胞白血病患儿血小板输注阈值及疗效分析  

Platelet transfusion threshold and curative efficacy analysis in 99 children with ALL

作　　者：付晓艳 邱立娟[1] 张帅行 马曙轩[1] FU Xiaoyan;QIU Lijuan;ZHANG Shuaihang;MA Shuxuan(Department of Transfusion Medicine,Beijing Children's Hospital,Capital Medical University,National Center for Childrens' Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院输血科,北京100045

出　　处：《中国输血杂志》2019年第2期103-106,共4页Chinese Journal of Blood Transfusion

摘　　要：目的分析99例急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)患儿血小板输注阈值及输注疗效,探讨输注次数对血小板输注无效率的影响。方法选取2017年1月1日—2017年12月31日本院初次确诊的需要输注血小板的ALL患儿99例,根据患儿输注血小板次数分为首次组、2次组、3次组和4次组,通过回顾性分析ALL患儿首次及多次输注血小板前后血小板计数值,用输注前血小板计数值作为患儿输注阈值,结合输注后血小板计数值计算患儿血小板计数纠正增加指数(CCI值),并判断输注疗效(1 h CCI<7.5×10~9/L或24h CCI<7.5×10~9/L为输注无效),比较4组患儿输注无效率差异。结果 4组患儿输注阈值分布在≤10×10~9/L的百分比分别为37.4%(37/99)、27.3%(15/55)、31.3%(15/48)和20.0%(8/40);4组患儿输注阈值分布在(11—20)×10~9/L的百分比分别为33.3%(33/99)、43.6%(24/55)、35.4%(17/48)和57.5%(23/40);4组患儿输注阈值分布在>20×10~9/L的百分比分别为29.3%(29/99)、29.1%(16/55)、33.3%(16/48)和22.5%(9/40)。4组患儿输注无效率的百分比分别为:7.07%(7/99)、16.4%(9/55)、18.8%(9/48)和27.5%(11/40),差异有统计学意义(P<0.05)。结论本研究结果显示,阈值较高时进行血小板输注的患儿仍占多数,患儿首次输注血小板疗效较好,但是随着输注次数增加,血小板输注无效率逐渐升高。Objective To analyze the optimum platelet transfusion threshold and monitor the response of platelet transfusion therapy in 99 children with ALL, and the number of platelet transfusionswas evaluated for its association with refractoriness. Methods From January 1,2017 to December 31,2017, a total of 99 ALL children with need for platelet transfusion were enrolled in our study. They were subdivided into 4 subgroups, i.e.the first-timetransfusion group, the 2 transfusions group, the 3 transfusions group and the 4 transfusions group, according to the number of platelet transfusions administered.We analyzed retrospectively the platelet count before and after the first-time and repeated transfusions.The platelet countbefore transfusion was used to analyze the transfusion threshold,and CCI was calculated by post transfusion platelet count. The response to each platelet transfusion was assessed by estimating CCI at 1 h and 24 h(1 h CCI<7.5×10^9/L or 24 h CCI<7.5×10^9/L were labeled as refractory), and the differences in the incidence of platelet transfusion refractory among 4 groups were compared. Results In the 4 subgroups, the proportion of platelet transfusion utilizing threshold of ≤10×10^9/L was 37.4%(37/99), 27.3%(15/55), 31.3%(15/48) and 20.0%(8/40), respectively;the proportion of transfusion utilizing threshold among(11-20)× 10^9/L was 33.3%(33/99),43.6%(24/55),35.4%(17/48) and 57.5%(23/40), respectively;the proportion of transfusion utilizing threshold of >20×10^9/L was 29.3%(29/99), 29.1%(16/55), 33.3%(16/48) and 22.5%(9/40), respectively. The incidence of platelet transfusion refractory in 4 groups were 7.07%(7/99), 16.4%(9/55), 18.8%(9/48) and 27.5%(11/40),respectively, and the difference among them was statistically significant(P<0.05).Conclusion The results above showed that the threshold for platele ttransfusion is high among most children with ALL, and the first-time platelet transfusion had a better outcome, and the incidence of platelet transfusion refractory was associated with an increase in th

关 键 词：急性淋巴细胞白血病 儿童 输注阈值 血小板计数纠正增加指数 血小板输注无效 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]