化疗患者血小板输注疗效的影响因素研究  

Factors that influence the therapeutic effect of platelet transfusion in patients undergoing chemotherapy

作　　者：韩蕊[1] 林文前[1] 刘裔军 刘万里[1] 陈文力 翁雪姿 陈琦[1] 张明娟[1] 柯妙拉[1] HAN Rui;UN Werujian;LIU Yijun;UU Wanli;CHEN Wenli;WENG Xuezi;CHEN Qi;ZHANG Mingjuan;KE Miaola(Department of Blood Transfusion,Sun Yet San University Cancer Center,Guangzhou 510060,China;Sun Yet San University Cancer Center)

机构地区：[1]中山大学肿瘤防治中心输血科

出　　处：《中国输血杂志》2019年第11期1131-1133,共3页Chinese Journal of Blood Transfusion

基　　金：广东省医学科学技术研究基金项目(A2016039)

摘　　要：目的探讨恶性肿瘤患者化疗后行血小板输注的疗效及其影响因素。方法2016年10月-2018年4月期间,符合纳入标准的450例次血小板输注化疗患者,通过测定校正血小板计数增加值(CCI)或判断出血症状是否改善,将其分为血小板输注有效组和无效组,并对2组患者性别、年龄、Karnofsky功能状态评分(KPS评分)、有无发热、化疗次数、化疗药种类数量、是否应用重组人血小板生成素(rhTPO)、血小板输注次数、血小板抗体等因素进行单因素及多因素回归分析。结果450例次血小板输注患者,有效率74.9%(337/450),无效率25.1%(113/450)。比较2组性别、KPS评分、是否发热等因素,无统计学差异(P>0.05)。无效组中年龄、化疗次数、化疗药种类数量、应用rhTPO、输注次数、人类白细胞抗原(HLA)抗体阳性等与有效组比较,有统计学差异(P<0.05)。多因素回归分析显示:年龄>12岁、化疗次数>6次、化疗药种类数量>2类、HLA抗体阳性是影响肿瘤化疗患者血小板输注疗效的独立危险因素。结论化疗患者血小板输注疗效既与化疗疗程、化疗药物种类、联合用药有关,也涉及免疫因素。Objective To investigate the therapeutic effect of platelet transfusion in patients with malignant tumors after chemotherapy-induced thrombocytopenia and its influencing factors.Methods 450 patients with platelet transfusion for chemotherapy who met the criteria from October 2016 to April 2018 had been included in the study.According to the platelet corrected count increment(CCI)or judging whether hemorrhagic symptoms had been improved,patients were divided into effective and ineffective groups.Univariate and multivariate regression analysis were used to such indicator analysis as gender,age,Karnofsky(KPS)score,fever,chemotherapy times,the number of chemotherapeutic drugs,application of recombinant human thrombopoietin(rhTPO),numbers of platelet transfusion and platelet antibody.Results The effective and ineffective rates of platelet transfusion were 74.9%(337/450)and 25.1%(113/450)respectively.There were no statistical differences in gender,KPS score and fever between two groups(P>0.05).There were statistical differences in age,chemotherapy times,the number of chemotherapy drugs,application of rhTPO,numbers of platelet transfusion and human leukocyte antigen(HLA)antibody between two groups(P<0.05).Logistic regression analysis showed that age over 12 years,chemotherapy more than 6 times,chemotherapy drugs more than 2 types and HLA antibody were independent risk factors affecting the efficacy of platelet transfusion in tumor patients undergoing chemotherapy.Conclusion The therapeutic effect of platelet transfusion in patients undergoing chemotherapy is related to not only chemotherapy times,chemotherapy drugs types and drugs combination,but also immune factors.

关 键 词：肿瘤 化疗导致的血小板减少症 血小板输注无效 人类白细胞抗原 人类血小板特异性抗原 

分 类 号：R730.53[医药卫生—肿瘤] R457.1[医药卫生—临床医学]