X射线辐照单采少白细胞血小板临床输注效果研究  

Study on the clinical transfusion effect of X-ray irradiated apheresis leukoreduced platelets

作　　者：孙丽 刘胜男 王慧 单梦 刘金英 王海霞 SUN Li;LIU Shengnan;WANG Hui;SHAN Meng;LIU Jinying;WANG Haixia(Department of Blood Transfusion,Affiliated Hospital of Shandong Second Medical University,Weifang 261031,China)

机构地区：[1]山东第二医科大学附属医院输血科,山东潍坊261031

出　　处：《山东第二医科大学学报》2025年第1期38-42,共5页Journal of Shandong Second Medical University

基　　金：潍坊医学院附属医院医学研究培育基金项目(项目编号:2021wyfyzzjj08);潍坊市科技发展计划(医学类)项目(项目编号:2020YX029)。

摘　　要：目的 探讨X射线辐照单采少白细胞血小板的临床输注效果。方法 选取2021年1月~2021年6月在我院就诊申请输注血小板的患者共计102例,分为单采输注组(59例)、混合输注组(18例)和辐照输注组(25例)3组。应用输血系统、HIS系统、LIS系统追踪其在2018年6月~2021年6月期间的血小板输注情况,记录输注血小板的种类、存储时间,患者的性别、年龄、体重、临床诊断、血小板输注次数、输血前及输血后24 h内血红蛋白含量、血小板计数、血小板回收率(PPR)及出血症状有无改善、输血不良反应情况,纳入存在差异的影响因素,构建多因素Logistic回归方程,进行统计学分析。结果 3组患者共计输注668次血小板,血小板输注次数:单采输注组3(2,7)次,辐照输注组5(1,26)次,混合输注组16(6,49)次,组间比较,差异均有统计学意义(P<0.0167)。活动性出血率:混合输注组为41.6%,辐照输注组为54.0%,单采输注组为55.3%,混合输注组与单采输注组比较,差异有统计学意义(P<0.0167);辐照输注组与混合输注组比较,差异有统计学意义(P<0.0167),而与单采输注组比较,差异无统计学意义(P>0.0167)。血小板输注有效率:单采输注组为86.9%,混合输注组为90.4%,辐照输注组为93.1%,组间比较,差异无统计学意义(P>0.05)。纳入血小板输注次数、是否存在活动性出血、研究分组3个因素,构建多因素Logistic回归方程,发现血小板输注次数、活动性出血是血小板输注有效的危险因素,影响有统计学意义(OR<1,P<0.05);输注X射线辐照血小板是血小板输注有效的保护性因素,对血小板输注效果的影响有统计学意义(OR>1,P<0.05)。结论 X射线辐照单采少白细胞血小板输注是血小板输注有效的保护性因素,临床输注效果优于单采少白细胞血小板。Objective To explore the clinical transfusion effects of X-ray irradiated apheresis leukoreduced platelets.Methods During January to June in 2021,102 patients who received platelet transfusions in affiliated hospital of Shandong second medical university were divided into three groups:apheresis transfusion group(59 patients),mixed transfusion group(18 patients)and irradiated transfusion group(25 patients).Patient information and transfusion records from June 2018 to June 2021 were tracked using the blood transfusion system,HIS system,and LIS system.Data was col-lected including platelet type,storage duration,patient demographics(gender,age,weight),clinical diagnosis,platelet transfusion frequency,hemoglobin levels before and 24 hours after transfusion,platelet count,platelet recovery rate(PPR),improvement in bleeding symptoms,and transfusion-related adverse reactions.Factors with significant differences were included for following multivariate logistic regression analysis.Results A total platelets counts of 668 were trans-fused in three groups of patients,differences in platelet storage time and basic information of patients were not statistically significant(P>0.05).The differences of the platelets transfusion times were statistically significant(P<O.0167),3(2,7)times in the apheresis transfusion group,5(1,26)times in the irradiated transfusion group,and 16(6,49)times in the mixed transfusion group.The active bleeding rates were 41.6%in mixed transfusion group,54.0%in irradiated transfusion group,and 55.3%in apheresis transfusion group.The difference was statistically significant when comparing mixed transfusion group with single transfusion group(P<0.0167);the difference was statistically significant when com-paring the irradiated transfusion group with the mixed transfusion group(P<0.0167),while difference was not statistical-ly significant comparing with single transfusion group(P>0.0167).The effective rates of platelet transfusions were 86.9%in apheresis transfusion group,90.4%in mixed group,and 93.1%in irra

关 键 词：X射线辐照单采少白细胞血小板 单采少白细胞血小板 输注效果 辐照源 多因素Logistic回归 

分 类 号：R457.1[医药卫生—治疗学]