MDS患者反复输注血小板的输血效果及其影响因素分析  

Analysis of the Effect and Influencing Factors of Repeated Platelet Transfusion in MDS Patients

作　　者：魏秀萍[1] WEI Xiuping(Department of Blood Transfusion,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China)

机构地区：[1]潍坊市中医院输血科,山东潍坊261041

出　　处：《中国医学创新》2024年第15期153-157,共5页Medical Innovation of China

摘　　要：目的:探讨骨髓增生异常综合征(MDS)患者反复输注血小板的输血效果,并分析影响血小板输注无效(PTR)的因素。方法:选取2019年1月—2022年12月潍坊市中医院收治的63例MDS患者为此次研究对象。依据PTR判定标准[输血后24 h校正血小板增高指数值(CCI)≤4、血小板回升率(PPR)≤20%]评估入组对象输血效果,logistic回归分析影响MDS患者PTR的因素。结果:入组63例MDS患者中,34例(53.97%)输注有效,29例(46.03%)输注无效。有效组与无效组在血小板抗体阳性、发热、脾肿大、P-选择素、人抗凝血酶3抗体水平比较上差异均有统计学意义(P<0.05),在性别、年龄、体重指数(BMI)、病程、WHO分型、国际预后评分(IPSS-R)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)比较,差异均无统计学意义(P>0.05)。单因素logistic分析结果显示,上述有统计学差异的指标均为影响MDS患者PTR的相关因素(P<0.05)。多因素logistic回归分析结果显示,血小板抗体阳性、P-选择素、人抗凝血酶3抗体升高均为影响MDS患者PTR的危险因素(OR=1.855、1.927、1.984,P<0.05)。结论:MDS患者反复输注血小板的输血效果不甚理想,PTR主要与血小板抗体阳性、P-选择素和人抗凝血酶3抗体水平有关。Objective:To explore blood transfusion effect of repeated platelet transfusion in patients with myelodysplastic syndrome(MDS),and to analyze the influencing factors of platelet transfusion refractoriness(PTR).Method:Sixty-three patients with MDS admitted to Weifang Hospital of Traditional Chinese Medicine from January 2019 to December 2022 were selected as the study objects.According to PTR criteria(CCI≤4 at 24 h after blood transfusion,PPR≤20%),blood transfusion effect was evaluated.The influencing factors of PTR in MDS patients were analyzed by logistic regression analysis.Result:Among the 63 patients with MDS,there were 34 cases(53.97%)with effective transfusion and 29 cases(46.03%)with ineffective transfusion.There were significant differences in platelet antibody positive,fever,splenomegaly,P-selectin and human antithrombin 3 antibody between effective group and ineffective group(P<0.05),but there were no differences in gender,age,BMI,course of disease,WHO classifications,IPSS-R,prothrombin time(PT)or activated partial thromboplastin time(APTT)between the two groups(P>0.05).The results of univariate logistic analysis showed that the above indexes with statistical differences were all related influencing factors of PTR in MDS patients(P<0.05).The results of multivariate logistic regression analysis showed that platelet antibody positive,increased P-selectin and human antithrombin 3 antibody were all influencing factors of PTR in MDS patients(OR=1.855,1.927,1.984,P<0.05).Conclusion:The blood transfusion effect of repeated platelet transfusion is not satisfactory in MDS patients.PTR is mainly related to platelet antibody positive,P-selectin and human antithrombin 3 antibody.

关 键 词：骨髓增生异常综合征 血小板输注无效 危险因素 血小板抗体 

分 类 号：R457.1[医药卫生—治疗学] R551.3[医药卫生—临床医学]