Kim Han Joo, Yang John Jeongseok, Kim Hyungsuk, Hwang Sang-Hyun, Oh Heung-Bum, Chung Yousun, Ko Dae-Hyun
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Lab Med. 2022 May 5;53(3):266-272. doi: 10.1093/labmed/lmab092.
We designed a study to compare the efficacy of cryoprecipitate-reduced plasma (CRP) and fresh frozen plasma (FFP), at the level of individual sessions, for treating refractory thrombotic microangiopathy (TMA) with therapeutic plasma exchange (TPE).
Platelet counts (× 10³/μL) and lactate dehydrogenase (LD; IU/L) levels were measured before and after each session. We compared the mean-percentage and absolute changes in platelet count and LD after each TPE session.
The data from 33 patients treated for TMA between 2009 and 2018 were collected for this study. Both absolute and percentage increases in the platelet count were statistically significant (P = .003 and P = .011, respectively) when CRP was used. However, when patients were divided into subgroups according to specific diagnosis, no significant differences were found among the groups, except in terms of the absolute platelet count increase in the thrombotic thrombocytopenic purpura group (P <.001).
The platelet count increase was higher when patients received CRP than when they received FFP. We found that CRP may be a rescue option for patients with refractory TMA.
我们设计了一项研究，以比较在单次治疗中，冷沉淀减少血浆（CRP）和新鲜冰冻血浆（FFP）在治疗性血浆置换（TPE）治疗难治性血栓性微血管病（TMA）时的疗效。
在每次治疗前后测量血小板计数（×10³/μL）和乳酸脱氢酶（LD；IU/L）水平。我们比较了每次TPE治疗后血小板计数和LD的平均百分比变化及绝对变化。
本研究收集了2009年至2018年间33例接受TMA治疗患者的数据。使用CRP时，血小板计数的绝对增加和百分比增加均具有统计学意义（分别为P = 0.003和P = 0.011）。然而，当根据具体诊断将患者分为亚组时，除血栓性血小板减少性紫癜组血小板计数的绝对增加外（P < 0.001），各亚组之间未发现显著差异。
患者接受CRP治疗时血小板计数的增加高于接受FFP治疗时。我们发现CRP可能是难治性TMA患者的一种挽救选择。
