高量减除血小板治疗对血小板增多症患者白细胞数及血红蛋白水平的影响  

Effect of Highvolume Platelet Reduction Therapy on White Blood Cell Count and Hemoglobin Level in Patients with Thrombocytosis

作　　者：吴远军 吴勇 李惠森 陈宝婵 刘艳 吴月勤 梁思远 梁美琪 WU Yuan-Jun;WU Yong;LI Hui-Sen;CHEN Bao-Chan;LIU Yan;WU Yue-Qin;LIANG Si-Yuan;LIANG Mei-Qi(Department of Blood Transfusion,Dong guan Maternal and Child Health Care Hospital,Dongguan 523120,Guangdong Province,China;Department of Blood Transfusion,Dongguan Donghua Hospital,Dongguan 523110,Guangdong Province,China)

机构地区：[1]东莞市妇幼保健院输血科,广东东莞523120 [2]东莞东华医院输血科,广东东莞523110

出　　处：《中国实验血液学杂志》2019年第5期1607-1611,共5页Journal of Experimental Hematology

基　　金：2019年东莞市社会科技发展(重点)项目

摘　　要：目的:探讨高量减除血小板治疗对血小板增多症患者外周血白细胞数(WBC)及血红蛋白(Hb)水平的影响。方法:采用COBE Spectra连续流动离心式血液成分分离机ELP或MNC程序,以ACD-A配方血液保存液作为抗凝剂,对21例血小板增多症患者共实施32次高量减除血小板治疗,每次治疗处理2.5-3.0倍总血容量(TBV),采集1/5-1/4倍TBV的血小板悬液。结果:单次治疗运行时间(212.53±41.54)min;处理血量(8812.63±2087.15)ml;采集血小板悬液容量(798.84±190.77)ml;悬液血小板数(Plt)4486.50(3058.50-5279.50)×10^9/L、血小板总数3455.50(2288.68-4226.71)×10^9;WBC 13.79(10.21-20.72)×10^9/L、白细胞总数11.90(7.81-14.40)×10^9;Hb水平(3.28±1.25)g/L,Hb总量(2.62±1.17)g。治疗前、后患者循环血液Plt分别为1263.00(1052.50-1807.50)×10^9/L、(778.83±247.25)×10^9/L(Z=4.94,P<0.01),WBC分别为9.96(6.44-14.01)×10^9/L、8.59(5.37-13.12)×10^9/L(Z=13.31,P<0.05),Hb水平分别为(112.63±24.56)g/L、(10^9.55±24.46)g/L(t=1.68,P>0.05)。结论:采用连续流动离心式血液成分分离术,对血小板增多症患者实施高量减除血小板治疗,可显著降低患者体内血小板负荷,提高减除血小板治疗的采集效率;虽可导致患者WBC有所下降,但WBC仍可维持在正常范围内;对患者Hb水平没有显著性影响。Objective:To explore the effect of high volume platelet reduction therapy on the white blood cell(WBC)count and hemoglobin(Hb)level in patients with thrombocytosis.Methods:Thirty-two plateletphoreses were performed for patients with thromocytosis by using ELP or MNC program of blood component isolator of COBE spectra continuous flow concentrifugation and the ACD-A preservation solution for blood as blood anticoagulant.In each treatment of patients,2.5-3.0 tines total blood volume(TBV)were circulated,then the platelet suspension of 1/5-1/4 time TBV was prepared and collected.Results:A single plateletpheresis took(212.53±41.54)minutes in which(8 812.63±2087.15)ml blood were treated,and(798.84±190.77)ml platelet suspension was collected.In the suspension,the platelet count was 4 486.50(3 058.50-5 279.50)×10^9/L,containing 3 455.50(2 288.68-4 226.71)×10^9.WBC count was 13.79(10.21-20.72)×10^9/L,containing 11.90(7.81-14.40)×10^9.Hemoglobin concentration was(3.28±1.25)g/L,containing(2.62±1.17)g.Before and after plateletpheresis,the patients’platelet count was 1 263.00(1 052.50-1 807.50)×10^9/L and(778.83±247.25)×10^9/L(Z=4.94,P<0.01),WBC count was 9.96(6.44-14.01)×10^9/L and 8.59(5.37,13.12)×10^9/L(Z=13.31,P<0.05),Hemoglobin concentration was(112.63±24.56)g/L and(10^9.55±24.46)g/L(t=1.68,P>0.05).Conclusion:Using continuous flow centrifugation and blood component separating in plateletpheresis for the patients with thrombocytosis can obviously decrease the high ratio of platelets,and improve the effect of plateletpheresis.The high volume platelet reduction therapy can lead to decrease of WBC count to some alent,degree but WBC count still in the normal range,moreover not affect the hemoglobin level significantly.

关 键 词：血小板增多症 血小板单采术 血红蛋白 白细胞数 血液成分分离机 

分 类 号：R558.3[医药卫生—血液循环系统疾病]