急性白血病患者血小板输注疗效的影响因素研究  

Analysis of influencing factors on the efficacy of platelet transfusion in patients with acute leukemia

作　　者：王晶 卫淑娟 梁娜 田丹丹 何昊兰 Wang Jing;Wei Shujuan;Liang Na(Department of Hematology,the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Military Medical University,Xi′an 710061,China)

机构地区：[1]解放军空军军医大学第一附属医院血液内科,西安710061

出　　处：《中华保健医学杂志》2024年第3期313-315,共3页Chinese Journal of Health Care and Medicine

基　　金：陕西省重点研发计划(2022JQ873)。

摘　　要：目的 分析急性白血病(AL)患者血小板输注疗效的影响因素。方法 选取2019年4月~2023年4月于解放军空军军医大学第一附属医院血液内科治疗的AL患者143例。输注标准为血小板计数≤10×10^(9)/L,一般情况稳定,或血小板计数> 10×10^(9)/L,但有明显出血征象。均输注单采血小板,以血小板增加指数结合出血改善情况判断疗效。对患者性别、年龄、血型、白细胞(WBC)计数、AL类型、输注次数、血小板库存期、是否存在发热、感染、脾大、药物使用情况等进行比较。采用logistic回归分析疗效影响因素。结果 143例患者共输注血小板次数2 167次,其中无效输注47例(无效组),有效组96例。单因素分析结果显示,性别、年龄、AL类型、血型、血小板库存期及是否进行骨髓移植、是否存在DIC输注有效和无效组间差异无统计学意义(P> 0.05),两组WBC计数、输注次数、脾大、发热、感染、使用抗生素差异有统计学意义(P<0.05)。logistic回归分析得出WBC> 50×10^(9)/L、输注次数> 5次、脾大、感染为发生血小板无效输注的独立风险因素(OR=1.531、1.736、1.136、2.010,P<0.05)。结论 WBC异常升高、脾大、感染及多次输注患者更易发生血小板无效输注,应及早采取措施,改善患者预后。Objective To analyze the influencing factors of platelet transfusion efficacy in patients with acute leukemia.Methods A total of 143 patients with acute leukemia treated in our department from April 2019 to April 2023 were selected as the study subjects.Platelet transfusion was administered based on the criteria of platelet count≤10×109 L or>10×109 L with evident signs of bleeding.All patients were infused with single collected platelets,and the efficacy was evaluated based on the platelet growth index combined with the improvement of bleeding.Compare the patient′s gender,age,blood type,WBC count,AL type,number of transfusions,platelet inventory period,presence of fever,infection,splenomegaly,and medication use.Logistic regression analysis was used to analyze the influencing factors of efficacy.Results Univariate analysis showed no statistically significant differences in gender,age,AL type,blood type,platelet inventory period,whether bone marrow transplantation was performed,and whether DIC was present(P>0.05).However,significant differences were observed in WBC count,infusion frequency,splenomegaly,fever,infection,and antibiotic use(P<0.05).Logistic regression analysis shows WBC>50×109 L.Infusion frequency>5 times,splenomegaly,and infection are independent risk factors for ineffective platelet transfusion(OR=1.531,1.736,1.136,2.010,P<0.05).Conclusion Patients with abnormal elevation of WBC count,splenomegaly,infection,and multiple transfusions are at higher risk of ineffective platelet transfusion.Early interventions should be implemented to improve patient prognosis.

关 键 词：急性白血病 血小板无效输注 疗效 非免疫因素 

分 类 号：R55[医药卫生—血液循环系统疾病]