不同存储时间的血小板对脓毒症患者近期预后的影响  

Effects of different storage durations of platelet on short-term prognosis in patients with sepsis

作　　者：王拥军[1] 李玉娇[1] WANG Yong-jun;LI Yu-jiao(Department of Blood Transfusion,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院输血科,乌鲁木齐市830054

出　　处：《广西医学》2020年第5期533-536,547,共5页Guangxi Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2017D01C216)。

摘　　要：目的探讨不同存储时间的血小板对脓毒症患者预后的影响。方法回顾性分析接受血小板输注的139例脓毒症患者的临床资料。根据血小板存储时间将患者分为A组(≤3 d)76例和B组(4~5 d)63例。比较两组血小板输注前及输注后1 d炎症指标、凝血指标水平以及损伤严重程度评分、序贯器官衰竭评估量表。记录患者入ICU后28 d病死率,比较两组死亡风险。采用Cox回归模型分析患者死亡的危险因素。结果输注血小板1 d后,两组炎症指标、凝血指标及各项量表评分均较前改善(均P<0.05),但组间差异无统计学意义(P>0.05)。A组、B组28 d病死率分别为30.26%(23/76)、31.74%(20/63),但组间死亡风险差异无统计学意义(P>0.05)。年龄≥55岁以及入ICU时格拉斯昏迷评分量表评分≤8分、简明损伤量表评分≥3分、血乳酸水平≥2 mmol/L是导致脓毒症患者死亡的独立危险因素(均P<0.05),但血小板存储时间与患者死亡无关(P>0.05)。结论血小板的存储时间对脓毒症患者近期预后并无影响,但临床上在输注血小板时仍需尽量选择存储时间较短的批次。Objective To investigate the effects of different storage durations of platelet on the short-term prognosis of patients with sepsis.Methods The clinical data of 139 sepsis patients receiving platelet transfusion were retrospectively analyzed. The patients were divided into 76 cases in group A(≤3 days) and 63 cases in group B(4-5 days) according to storage duration of platelet. The levels of inflammatory indexes and coagulation indexes, as well as injury severity scores and the Sequential Organ Failure Assessment scores were compared between the two group before platelet transfusion and one day after transfusion. The 28-day case fatality rate of patients after ICU admission was recorded, and death risks were compared between the two groups. Cox regression model was applied to assessing the risk factors for mortality in the patients. Results One day after platelet transfusion, the inflammatory indexes, coagulation indexes and scores for each item of the scale were improved in both group(all P<0.05), but no statistically significant difference was found between groups(P>0.05). The 28-day case fatality rates of group A and group B were 30.26%(23/76)and 31.74%(20/63),respectively, but there was no statistically significant difference in death risks between the two groups(P>0.05). The Glasgow Coma Scale score ≤ 8 points, the Abbreviated Injury Scale score ≥ 3 points, and blood lactate level ≥ 2 mmol/L at ICU admission, as well as age ≥ 55 years were the independent risk factors for mortality in patients with sepsis(all P<0.05), but the storage duration of platelet had no correlation with the death of the patients(P>0.05). Conclusion The storage duration of platelet has no effect on the short-term prognosis of patients with sepsis, but it is still necessary to select the batches with shorter storage duration when platelets transfusion clinically.

关 键 词：脓毒症 血小板 存储时间 近期预后 

分 类 号：R459.7[医药卫生—急诊医学]