新生儿低阈值血小板输注策略的研究进展  

Research progress of neonatal low-threshold platelet transfusion strategy

作　　者：梁春峰[1] 何秀梅 吴晶晶 蔡燕华 陈峋 LIANG Chunfeng;HE Xiumei;WUJingjing;CAI Yanhua;CHEN Xun(Department of Blood Transfusion,The First Affliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Clinical Medicine,School of Oncology,Guangxi Medical University;Pediatric Intensive Care Unit,The First Affiliated Hospital of Guangxi Medical University)

机构地区：[1]广西医科大学第一附属医院输血科,广西南宁530021 [2]广西医科大学肿瘤医学院临床医学系 [3]广西医科大学第一附属医院儿童重症监护病房

出　　处：《中国输血杂志》2023年第4期348-353,共6页Chinese Journal of Blood Transfusion

摘　　要：新生儿血小板减少症是新生儿,尤其是早产儿常见的血液学异常之一。血小板输注作为治疗新生儿血小板减少症的有效手段,其阈值选择及时机存在争议。最近的研究结果支持在新生儿中使用较低的血小板输注阈值(25×10^(9)/L),并强调了开放性输血策略可能带来的潜在危害。目前的临床实践中,新生儿血小板输注量大大超过成人常规使用的量,但新生儿和成人血小板之间存在显著的功能差异,血小板可能通过多种方式介导包括免疫细胞功能调节和血管炎症在内的若干生物学过程。本文就新生儿血小板输注最新的循证医学证据,对新生儿实行限制性输血策略的病理生理依据,ABO血型不相同血小板输注,以及血小板输注相关不良事件的发病现状及潜在机制做一综述。Neonatal thrombocytopenia is one of the common hematological abnormalities in neonates,especially premature infants.Platelet transfusion is an effective method of treating neonatal thrombocytopenia,but its threshold selection and timing are controversial.Recent findings support the use of a lower platelet transfusion threshold(25×10^(9)/L)in neonates and highlight the potential harm that may arise from liberal blood transfusion strategy.In current clinical practice,the volume of neonatal platelet transfusion greatly exceeds that routinely used in adults,but there are significant functional differences between neonatal and adult platelets,and platelets may mediate several immune and inflammatory responses in multiple ways.In this paper,based on the recent developments of evidence-based medical evidence of neonatal platelet transfusion,we summarized the pathophysiological basis of neonatal restrictive blood transfusion strategy,platelet transfusion with different ABO blood types,and the pathogenesis and potential mechanism of adverse events related to platelet transfusion.

关 键 词：新生儿 血小板输注 阈值 血小板减少症 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]