血液肿瘤患者输注血小板前后体温变化与输注效果的关系分析  

Analysis of the relationship between body temperature changes and the efficiency in hematopoietic patients before and after platelets transfusion

作　　者：张丽清 朱鑫方 杜丹心 乌宇波 杨李辉 夏荣 ZHANG Liqing;ZHU Xinfang;DU Danxin;WU Yubo;Yang Lihui;XIA Rong(Depart-ment of Blood Transfusion,Huashan Hospital Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院输血科

出　　处：《中国输血杂志》2019年第10期1008-1010,共3页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金(81670173);复旦大学附属华山医院科研启动基金2016QD07)

摘　　要：目的了解血液肿瘤患者输注血小板后体温变化与血小板输注效果的关系。方法选择符合条件[1)每次输注单采血小板1袋,且同时未输注红细胞;2)本次入院首次输注血小板;3)血小板输注前无出血;4)血小板抗体(抗-HLA、抗-HPA)检测阴性;5)年龄在18-65岁]的1250例已输注血小板的血液肿瘤病例。按患者输注前后体温变化情况分为A组(n=789):患者输注血小板前<24 h体温(T)<38℃(包括体温正常及低度发热患者),B组(n=461):患者输注血小板前<24 h T≥38℃(包括中度和高度发热患者);△T1组(n=1034):患者输注血小板后<24 h T升高幅度<1℃(含部分A组和部分B组患者),△T2组(n=216):患者输注血小板后<24 h T升高幅度≥1℃(含部分A组和部分B组患者)。收集患者的人口学基本信息,输注血小板前后体温、血小板水平等;分析患者输注前后体温变化与输注有效率[输后24 h校正血小板增加值(CCI)>4.5和实际血小板回收率(PPR)>40%为有效]。结果输注血小板前后24 h平均体温(℃):A组为37.2±0.4 vs 37.8±0.8(P<0.05),B组为38.9±0.6 vs 38.8±0.8(P>0.05)。患者输注血小板后24 h CCI>4.5和PPR>40%的比例:A组为38.3%和44.8%,B组为7.8%和11.1%(P<0.05);△T1组为43.3%和50.2%,△T2组为7.2%和7.1%(P<0.05)。结论血液肿瘤患者输注血小板后<24 h体温升高,中、高度发热患者血小板输注效果差于低热或体温正常患者。输注前后发热是引起血小板输注无效的因素之一。Objective To investigate the relationship between changes in body temperature and platelet transfusion efficiency before and after transfusion in patients with hematologic malignancies.Methods A total of 1250 cases of hematologic malignancies with platelets transfused were selected:1)One bag of platelets per infusion and no red blood cells transfused at the same time;2)Platelets were infused for the first time in the hospital;3)No bleeding before platelet transfusion;4)Negative detection of platelet antibodies(anti-HLA,anti-HPA);5)Age between 18 and 65 years old.Grouping was performed according to changes in body temperature before and after platelets transfusion.Group A:patients body temperature(T)<38℃within 24 hours before platelets transfusion(included patients with normal temperature and low fever).Group B:patients body temperature(T)≥38℃within 24 hours before platelets transfusion(included patients with moderate and high fever).Group△T1:patients body temperature increased less than 1℃after platelets transfusion within 24 h(included parts of patients in group A and B).Group△T2:patients body temperature increased more than 1℃after platelets transfusion within 24 h(included parts of patients in group A and group B).At the same time,basic demographic information of patients,including body temperature and platelets level before and after infusion were collected.The body temperature changes and infusion efficiency before and after transfusion were analyzed[corrected count increment(CCI)>4.5 and practical platelet recovery(PPR)>40%within 24 h after transfused were considered effective].Results The body temperature of patients before transfused in group A and group B was(37.2±0.4)℃and(38.9±0.6)℃,and the temperature after transfused within 24 h was(37.8±0.8)℃and(38.8±0.8)℃.Temperature of patients in group A increased by(0.6±0.4)℃(P<0.05),but there was no significant change in group B(P>0.05).The patients′proportion of CCI>4.5 and PPR>40%within 24 h after platelet transfusion in group A

关 键 词：血小板输注 血小板输注效率 体温变化 血小板输注无效 血液肿瘤患者 

分 类 号：R457.1[医药卫生—治疗学] R733[医药卫生—临床医学]