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364 例患者血小板输注的治疗效果及影响因素分析。

Therapeutic Efficacy of Platelet Transfusion and Analysis of Influencing Factors in 364 patients.

机构信息

Department of Blood Transfusion, Affiliated Hospital of Nantong University, Nantong, China.

Department of Hematology, Affiliated Hospital of Nantong University, Nantong, China.

出版信息

Acta Haematol. 2023;146(3):214-219. doi: 10.1159/000529542. Epub 2023 Feb 9.

DOI:10.1159/000529542
PMID:36758527
Abstract

INTRODUCTION

The aims of this study were to observe the therapeutic effect of platelet (PLT) transfusion and to analyze influencing factors for the sake of providing useful clues for improving the efficacy of PLT transfusion.

METHODS

Included in this study were patients who received PLT transfusion in the affiliated hospital of Nantong University. Patients' sex, age, height, weight, PLT transfusion status, and 20-24-h PLT count before and after PLT transfusion were collected to calculate the PLT corrected count increment values before and after PLT transfusion. Solid-phase red cell adherence assay was used to determine PLT antibody. Statistical analysis was performed using SPSS25.0 Software.

RESULTS

A total of 364 patients received 1,060 PLT transfusions, including 728 successful transfusions and 332 unsuccessful transfusions. When the patients were grouped according to different etiologies, significant differences in PLT transfusion effectiveness were observed between these groups (χ2 = 15.070, p < 0.05). Grouping of the 364 patients according to sex, blood type, and PLT transfusion frequency showed no significant difference in PLT transfusion refractoriness (PTR) between different age-groups and sexes (p > 0.05). With the number of PLT transfusions increasing, PTR increased gradually. PLT antibodies were detected of 364 patients, 67 of them were positive. Among them, 63 cases (94.02%) were positive for HLA class I antibody.

CONCLUSION

To reduce PTR, multiple factors should be considered comprehensively when PLT transfusion therapy is to be implemented in clinical practice. PLT antibody is the main immune factor causing PTR.

摘要

简介

本研究旨在观察血小板(PLT)输注的治疗效果,并分析影响因素,为提高 PLT 输注疗效提供有用线索。

方法

纳入在南通大学附属医院接受 PLT 输注的患者,收集患者的性别、年龄、身高、体重、PLT 输注情况以及 PLT 输注前后 20-24h 的 PLT 计数,计算 PLT 输注前后的 PLT 校正计数增加值。采用固相红细胞黏附试验测定 PLT 抗体。采用 SPSS25.0 软件进行统计学分析。

结果

共 364 例患者接受了 1060 次 PLT 输注,其中 728 次输注成功,332 次输注失败。当根据不同病因对患者进行分组时,发现这些组之间的 PLT 输注效果存在显著差异(χ2=15.070,p<0.05)。将 364 例患者按性别、血型和 PLT 输注频率分组,不同年龄段和性别之间的 PLT 输注难治性(PTR)无显著差异(p>0.05)。随着 PLT 输注次数的增加,PTR 逐渐增加。对 364 例患者进行 PLT 抗体检测,阳性 67 例,其中 HLA Ⅰ类抗体阳性 63 例(94.02%)。

结论

为了降低 PTR,在临床实践中实施 PLT 输注治疗时应综合考虑多种因素。PLT 抗体是导致 PTR 的主要免疫因素。

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