血液病化疗病人血小板输注疗效的影响因素研究  

Study on influencing factors of effect of platelet transfusion in patients with chemotherapy for hematological diseases

作　　者：江慧敏 许力 武琳琳 王晗晗 李萨萨 JIANG Huimin;XU Li;WU Linlin;WANG Hanhan;LI Sasa(Department of Hematology,Anhui No.2 Provincial People's Hospital,Hefei,Anhui 230041,China)

机构地区：[1]安徽省第二人民医院血液内科,安徽合肥230041

出　　处：《安徽医药》2023年第3期529-532,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省教育厅2019年度高校自然科学研究项目(KJ2019A1105)。

摘　　要：目的 探讨血液病化疗病人血小板输注疗效的影响因素。方法 回顾性分析2014年2月至2020年12月安徽省第二人民医院70例化疗后接受血小板输注治疗的恶性血液病病人的临床资料,依据血小板输注效果分为有效组(n=40)与无效组(n=30)。对比两组基础资料信息[性别、年龄、疾病类型、体质量指数(BMI)、血型、是否使用抗生素、是否使用升血小板药物、是否使用重组人血小板生成素(rhTPO)、化疗次数、化疗药物种类、血小板输注次数、是否合并糖尿病、是否合并高血压、输血前白细胞计数、输血前总胆红素]后将有差异信息纳入多因素logistic回归分析,探究对化疗病人血小板输注疗效的影响因素。结果 两组性别、年龄、疾病类型、BMI、血型、是否使用升血小板药物、是否合并糖尿病、是否合并高血压、输血前白细胞计数、输血前总胆红素对比差异无统计学意义(P>0.05);无效组使用抗生素率[28(93.33%)比24(60.00%)]、未使用rhTPO率[22(73.33%)比10(25.00%)]、化疗次数[(7.61±1.54)次比(5.16±1.02)次]、联合药物化疗率[25(83.33%)比6(15.00%)]、血小板输注次数[(7.36±2.84)次比(3.95±0.89)次]显著高于有效组(P<0.05)。采用多因素logistic回归分析论证,使用抗生素、未使用rhTPO、化疗次数>6次、化疗药物种类>2类、血小板输注次数≥5次是影响化疗病人血小板输注疗效的危险因素(均P<0.05)。结论 影响血液病化疗病人血小板输注疗效的因素较多,包括使用抗生素、未使用rhTPO、化疗次数>6次、化疗药物种类>2类、血小板输注次数≥5次,临床医师应当予以关注。Objective To explore the factors affecting the efficacy of platelet transfusion in patients with chemotherapy for hematological diseases.Methods The clinical data of 70 patients with hematological malignancies who received platelet transfusion after chemotherapy in Anhui No.2 Provincial People’s Hospital from February 2014 to December 2020 were retrospectively analyzed. According to the effect of platelet transfusion, patients were assigned into effective group(n=40) and ineffective group(n=30). The basic information of the two groups [gender, age, disease type, body mass index(BMI), blood type, whether to use antibiotics, whether to use platelet raising drugs, whether to use recombinant human thrombopoietin(rhTPO), number of chemotherapy, type of chemotherapy drugs, number of blood platelet transfusions, whether to combine diabetes, whether to combine hypertension, white blood cell count before blood transfusion, and total bilirubin before blood transfusion] were compared. After that, the difference information was included in the multivariate logistic regression analysis to clarify the risk factors that affect the efficacy of platelet transfusion in chemotherapy patients.Results There were no statistically significant differences between the two groups in gender, age, disease type, BMI, blood type, use of platelet-increasing drugs, diabetes, hypertension, pre-transfusion white blood cell count, and pre-transfusion total bilirubin(P>0.05).Rate of antibiotic use [28(93.33%) vs. 24(60.00%)], rate of no use of rhTPO [22(73.33%) vs. 10(25.00%)], frequency of chemotherapy [(7.61±1.54) times vs.(5.16±1.02) times], rate of combined drug chemotherapy [25(83.33%) vs. 6(15.00%)], platelet infusion times [(7.36±2.84) times vs.(3.95±0.89) times] in ineffective group were significantly higher than those in effective group(P<0.05). Multivariate logistic regression analysis was used to demonstrate that the use of antibiotics, no use of rhTPO, the number of chemotherapy times>6, the type of chemotherapy drugs>2, the numbe

关 键 词：血液肿瘤 血小板输注 化疗 血小板减少症 重组人血小板生成素 影响因素分析 

分 类 号：R733[医药卫生—肿瘤]