血液病患者血小板输注效果分析  

Analysis of the effect of platelet transfusion on patients with hematological diseases

作　　者：满志然[1] 张勇[2] 王永志[1] Man Zhiran;Zhang Yong;Wang Yongzhi(Department of Laboratory,Beijing No.6 Hospital,Beijing 100007,China)

机构地区：[1]北京市第六医院检验科,100007 [2]首都医科大学附属北京潞河医院血液科

出　　处：《北京医学》2021年第10期980-983,共4页Beijing Medical Journal

摘　　要：目的研究血液病患者血小板输注无效的相关因素。方法收集2012年1月至2019年1月北京市第六医院儿童及成人血液病反复住院的符合研究标准的283例患者共计1675例次机采血小板输注数据,根据输血后患者临床状态(出血情况停止或好转)和血小板增加指数(corrected count of increment, CCI)将患者分为血小板输注有效组和无效组。对可能导致血小板输注无效的因素(性别、年龄、疾病诊断、血型、脾大小、有无发热、有无输血过敏反应、血小板输注次数、输注前PLT、输注后24hPLT)进行分类统计分析。结果免疫性血小板减少症(immune thrombocytopenia, ITP)、再生障碍性贫血(aplastic anemia, AA)和骨髓增生异常综合征(myelodysplastic syndrome, MDS)血小板输注有效率较低,分别为43.8%、51.9%和57.6%。有妊娠史者血小板输注有效率下降(59.6%比70.8%),输注次数增多血小板输注有效率下降(88.8%降至56.3%),差异有统计学意义(P<0.05)。随着输注前PLT降低及患者年龄增加,输注有效率逐渐下降(78.0%降至52.0%,82.3%降至50.2%),差异均有统计学意义(P<0.05)。输注血小板时有发热(体温>38.3℃)、有输血过敏反应及脾大者输注有效率明显低于无发热、无输血过敏反应及无脾大者(51.9%比67.4%、52.6%比63.8%、50.6%比66.4%),差异均有统计学意义(P<0.05)。结论影响血小板输注疗效的因素包括患者年龄、妊娠史、发热、脾大、输注前PLT及血小板输注次数。Objective To explore the factors of ineffective platelet transfusion in patients with hematologic diseases. Methods A total of 1 675 machine-collected platelet transfusion data were collected from 283 patients with repeated hospitalizations of children and adults with hematological diseases in Beijing No.6 Hospital from January 2012 to January 2019, which met the research standards. Patients were divided into effective and ineffective platelet transfusion groups according to the clinical status of patients after blood transfusion(bleeding stopped or improved) and corrected count of increment(CCI). Factors that might cause platelet transfusion effect(gender, age, disease diagnosis, blood type, spleen size, fever, allergic reaction to blood transfusion, number of platelet transfusions, PLT before transfusion, 24 h PLT after transfusion) were statistical analyzed. Results Patients of immune thrombocytopenia(ITP), aplastic anemia(AA) and myelodysplastic syndrome(MDS) had lower platelet transfusion rates, which were 43.8%, 51.9% and 57.6% respectively. The effective rate of platelet transfusion decreased in people with a history of pregnancy(59.6% vs. 70.8%), and the effective rate of platelet transfusion decreased(88.8% to 56.3%) when the number of transfusions increased(P<0.05). As the PLT before infusion decreased and the patient’s age increased, the effective rate of infusion gradually decreased(78.0% to 52.0%, 82.3% to 50.2%), the differences were statistically significant(P<0.05). Patients with fever(body temperature >38.3 ℃), allergic reactions to blood transfusion and splenomegaly during platelet transfusion had a significantly lower transfusion efficiency than those without fever, allergic reactions to platelet transfusions, and no splenomegaly(51.9% vs. 67.4%, 52.6% vs. 63.8%, 50.6% vs. 66.4%), the difference were statistically significant(P<0.05). Conclusions The factors influencing the efficacy of platelet transfusion includes age, pregnancy history, fever, splenomegaly, PLT before transfusion and the

关 键 词：血小板输注无效 非免疫性 血液病 血小板输注 

分 类 号：R457.1[医药卫生—治疗学] R55[医药卫生—临床医学]