三种血小板制剂质量比较及对血液病患者输注的效果  

Quality Comparison of Three Platelet Preparations and Evaluation of Transfusion Effects in Patients with Hematological Diseases

作　　者：熊志高 李彦勋 程金凤 贺锋 XIONG Zhi-gao;LI Yan-xun;CHENG Jin-feng(Zhuzhou Blood Center,Zhuzhou Hunan 412000)

机构地区：[1]株洲市中心血站,湖南株洲412000 [2]长沙医学院附属株洲市人民医院检验科,湖南株洲412002 [3]湖南省株洲市中心医院输血科,湖南株洲412000

出　　处：《医学临床研究》2022年第6期819-822,共4页Journal of Clinical Research

基　　金：湖南省卫生健康委科研计划项目(20201481)。

摘　　要：【目的】比较混合浓缩血小板(血小板A)、新改良白膜法混合浓缩血小板(血小板B)、单采血小板(血小板C)制剂质量以及对血液病患者临床输注效果。【方法】比较三种血小板制剂的实验室指标,根据输注目的分为预防性输注、治疗性输注,比较输注前后血小板计数、血小板校正指数(CCI)、血小板回收率(PPR),判断预防性输注效果;比较输注前后出血分数,判断治疗性输注效果,并对不良输血反应进行统计分析。【结果】血小板A所含血小板数量低于血小板B和血小板C,红细胞(RBC)混入量高于其他两种血小板(P<0.05)。三种血小板制剂白细胞(WBC)混入量两两比较,差异均有统计学意义(P<0.05)。预防性输注时,同一组别内输注前血小板浓度低于输注后24h,且差异均有统计学意义(P<0.05),输注血小板A后24h血小板计数低于血小板C(P<0.05)。预防性输注131人次,输注无效率为22.90%,原发性免疫性血小板减少症(ITP)患者输注无效率高于其他疾病,且差异均有统计学意义(P<0.05)。治疗性输注时,同一组别内输注前出血分数高于输注后24h,差异均有统计学意义(P<0.05)。输注血小板A后24h出血分数高于其他两种血小板,差异有统计学意义(P<0.05)。血小板A不良输血反应发生率高于血小板C,差异有统计学意义(P<0.05)。【结论】血小板C、血小板B部分实验室指标、输注效果、不良输血反应发生率优于血小板A,血小板B可以作为单采血小板供给不足时的有效补充。【Objective】To compare the quality of mixed concentrated platelets(platelet A),newly improved buffy coat mixed concentrated platelets(platelet B)and apheresis platelets(platelet C)and the effect of clinical infusion in patients with hematological diseases.【Methods】The laboratory indexes of three platelet preparations were compared,which were divided into preventive infusion and therapeutic infusion according to the purpose of infusion.The platelet count,platelet correction index(CCI)and platelet recovery rate(PPR)before and after infusion were compared to judge the effect of preventive infusion.The blooding fraction before and after infusion was compared to judge the effect of therapeutic infusion,and the adverse transfusion reactions were statistically analyzed.【Results】The number of platelets in platelet A were lower than that in platelet B and platelet C,the mixed amount of red blood cells(RBC)was higher than that in the other kinds of platelets.There were significant differences in the mixed number of leukocytes(WBC)of three platelet preparations if compared in between(all P<0.05).During preventive infusion,the platelet concentration before infusion in the same group was lower than that 24 hours after infusion,and the difference was statistically significant(all P<0.05).The platelet count 24 hours after infusion in platelet A was lower than that in platelet C,and the difference was statistically significant(P<0.05).There were 131 times of prophylactic infusions,whose infusion ineffective rate was 22.90%.The infusion ineffective rate of ITP patients(primary immune thrombocytopenia)was higher than that of other diseases,and the difference was statistically significant(all P<0.05).During therapeutic infusion,the bleeding fraction before infusion in the same group was higher than that 24 hours after infusion,and the difference was statistically significant(P<0.05).The bleeding fraction 24 hours after infusion in platelet A was significantly higher than that in the other two platelets(P<0.05).The advers

关 键 词：血小板输注 血液病 血液成分输血 

分 类 号：R781.62[医药卫生—口腔医学]