配型血小板输注有效性的临床研究  

Efficacy of matched platelet transfusion

作　　者：邹小立[1] 陈澍英[1] 黄梓伦[1] 肖露露[2] 林伟[1] 叶欣[2] 黄铮人[1] 佘妙容[1] 唐继森[1] 杜欣[1] 谢蓉[1] 吴穗晶[1] 

机构地区：[1]广东省人民医院血液科,广州510080 [2]广州器官移植配型中心

出　　处：《临床血液学杂志》2003年第6期265-267,共3页Journal of Clinical Hematology

基　　金：广东省科委重点攻关项目 (编号 :1997 114 19) ;广东省人民医院科研基金资助项目 (编号 :2 0 0 0Y10 )

摘　　要：目的 :探讨配型血小板输注的临床效果。方法 :对 87例需要反复输注浓缩红细胞、血小板的恶性血液病患者采用淋巴细胞毒试验 (LCT)检测 ,研究患者血小板校正增加值测定 (CCI)与LCT、血小板输注无效之间的关系。经多次血小板输注产生同种抗体的部分患者 ,给予输注补体依赖交叉配型 (CDC)相合的血小板。结果 :87例患者共输注血小板 2 16次 ,其中CCI有效率为 71% ,CCI无效率为 2 9% ;CCI有效组LCT阳性率为 7.9% ,CCI无效组LCT阳性率为 2 4 .6 % ,CCI无效组LCT阳性率与CCI有效组相比差异有显著性意义 (χ2 =10 .4 ,P <0 .0 1) ;对 17例LCT阳性而血小板输注无效的患者共进行了 4 6例次CDC交叉配型血小板输注 ,CCI无效率分别为 :配型前 6 3.4 % ,配型后 35 .7% (χ2 =8.0 3,P <0 .0 1)。结论 :在 87例患者中 ,对产生同种抗体而导致血小板输注无效的部分患者 ,采用CDC交叉配型血小板输注效果较好。Objective:To explore the efficacy of matched platelet transfusion. Method:The relationship between the corrected count increment (CCI) of platelet and lymphocytotoxicity (LCT) and ineffective platelet transfusion were determinated in 87 patients with hematologic malignance who have received repeat red blood cell concentrate and platelet transfusion. The patients with antibody produced after many platelet transfusions were transfused with CDC matched platelet. Result:In 87 patients , 216 platelet were transfused. In CCI is 71% effective group, in CCI is 29.0% ineffective group, there is significant difference of LCT positive rate between ineffective and effective group (χ 2= 10.4,P< 0.01), For 17 LCT positive with ineffective platelet transfusion, they received 46 CDC matched platelet transfusions, before matched platelet transfusion ineffective CCI is 63.4% and after that is 35.7%, χ 2= 8.03,P< 0.01. Conclusion:For the patients with antibody produced after many platelet transfusions, transfusion with CDC matched platelet can get better results.

关 键 词：血液病 恶性 血小板输注 有效性 补体依赖交叉配型 

分 类 号：R552[医药卫生—血液循环系统疾病] R457.1[医药卫生—内科学]