血小板去除术治疗血小板增多症的临床疗效及安全性分析  

Analysis of the Clinical Efficacy and Safety of Platelet Ablation in the Treatment of Thrombocythemia

作　　者：李艳红[1,2,3] 聂波 杨金荣[4,5] 程沈菊 罗珊[1,2,3] 武坤 LI Yanhong;NIE Bo;YANG Jinrong;CHENG Shenju;LUO Shan;WU Kun(Department of Laboratory Medicine,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province,650032 China;Key Laboratory of Laboratory Medicine of Yunnan Province,Kunming,Yunnan Province,650032 China;Provincial Innovation Team of Clinical Laboratory Diagnosis,Kunming,Yunnan Province,650032 China;Department of Hematology,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province,650032 China;Yunnan Hematology Research Center,Kunming,Yunnan Province,650032 China)

机构地区：[1]昆明医科大学第一附属医院医学检验科,云南昆明650032 [2]云南省检验医学重点实验室,云南昆明650032 [3]临床检验诊断省创新团队,云南昆明650032 [4]昆明医科大学第一附属医院血液科,云南昆明650032 [5]云南省血液病研究中心,云南昆明650032

出　　处：《系统医学》2021年第21期57-60,共4页Systems Medicine

基　　金：云南省教育厅科学研究基金项目(2020J0172);云南省联合专项基金资助项目[2018FE001(-200)]。

摘　　要：目的研究血小板单采去除术对血小板增多症患者的血小板、高切、低切、血浆粘度和不良反应以及并发症的影响情况。方法选取2017年7月—2020年11月该院收治的185例血小板增多症患者,均以药物进行基础治疗,采用随机数表法,将患者分为观察组(n=93,加用血小板单采去除术)和对照组(n=92),比较联合治疗的效果和安全性。结果治疗前,观察组、对照组血小板计数、高切、低切、血浆黏度4项指标比较,差异无统计学意义(t=0.080、0.109、0.313、0.362,P>0.05);治疗后,两组4项指标明显改善,观察组均低于对照组,差异有统计学意义(t=17.927、4.860、7.984、13.613,P<0.05)。观察组、对照组发生出血、血管栓塞等并发症发生率分别为4.30%(4/93)和16.30%(15/92),观察组、对照组发生头晕、胸闷、心慌等不良反应发生率分别为2.15%(2/93)和14.13%(13/92),两组对比,差异有统计学意义(χ^(2)=7.231、8.909,P<0.05)。结论血小板增多症在短时间内会加大患者多器官血栓性出血的风险,而采用血小板单采去除术进行治疗能更有效地清除体内多余血小板,降低患者的血黏度,从而避免和减轻并发症及其造成的威胁,并且联合药物治疗的效果较好,能够减少患者的药物使用时间,从而减轻服药产生的不良反应,具有推广意义。Objective To study the effect of platelet apheresis removal on platelets,high shear,low shear,plasma viscosity,adverse reactions and complications in patients with thrombocytosis.Methods 185 patients with thrombocytosis treated in the hospital from July 2017 to November 2020 were selected,all of which were treated with drugs for basic treatment.Using a random number table method,the patients were divided into observation group(n=93,plus platelet apheresis removal)and control group(n=92)to compare the effect and safety of the combined treatment.Results Before treatment,there was no statistically significant difference in platelet count,high shear,low shear and plasma viscosity between the observation group and the control group(t=0.080,0.109,0.313,0.362,P>0.05);after treatment,the four indexes of the two groups were significantly improved,and the observation group was lower than the control group,and the difference was statistically significant(t=17.927,4.860,7.984,13.613,P<0.05).The rates of complications such as bleeding and vascular embolism in the observation group and the control group were 4.30%(4/93)and 16.30%(15/92),respectively,the rates of adverse reactions such as dizziness,chest tightness and palpitation in the observation group and the control group were 2.15%(2/93)and 14.13%(13/92),respectively,the difference between the two groups was statistically significant(χ^(2)=7.231,8.909,P<0.05).Conclusion Thrombocythemia can increase the risk of multi-organ thrombotic bleeding in a short period of time,the use of platelet apheresis for treatment can more effectively remove excess platelets from the body and reduce the patient's blood viscosity,thereby,complications and threats caused by them can be avoided and reduced,and the combined medical treatment has a better effect,can reduce the patient's drug use time,thereby reducing the adverse reactions caused by the medication,and has promotion significance.

关 键 词：血小板单采去除术 血小板增多症 疗效 安全性 

分 类 号：R556[医药卫生—血液循环系统疾病]