Kalish R I, Chambers L A, Linden J V
American Red Cross Blood Services, Connecticut Region, Farmington.
J Clin Apher. 1987;3(4):230-4. doi: 10.1002/jca.2920030408.
To evaluate the risk of significant plateletpheresis-induced thrombocytopenia in normal volunteer donors undergoing plateletpheresis less frequently than every 56 days and to help understand factors influencing platelet yield in these donors, pre- and postapheresis platelet counts (X 10(3)/microliter) and platelet yields were analyzed from 916 plateletpheresis procedures (Fenwal CS-3000) on 607 donors (405 men, 202 women). The mean preapheresis platelet count was 265 +/- 59 (SD) (range 155-650) (men 256 +/- 55 [170-444]; women 284 +/- 65 [155-650]; P less than .001, t-test). After an average platelet yield of 4.08 X 10(11), the mean postplatelet count was 185 +/- 46 (range 72-420) (men 184 +/- 42 [80-345]; women 194 +/- 52 [72-500]; P less than 0.1). The percent decrease in platelet count (mean 29.4 +/- 13, range -28.1-65.5) had positive correlations with platelet yield (P less than .01, r = 0.10), predonation platelet count (P less than .001, r = 0.29), and age (P less than .01, r = .10) and a negative correlation with weight (P less than .001, r = 0.18) Both the percent decrease and platelet yield were significantly higher in women than in men (P less than .001, t-test), and platelet yield was best predicted by preapheresis platelet count in both sexes (r = 0.65). The effects of plateletpheresis on donor platelet count thus vary widely among donors. Although a decrease of greater than 50% was not a rare event (5.9% of all procedures), in only three instances (0.3%) was the actual postapheresis platelet count below 100 (72, 94, 95). Thus, plateletpheresis in normal donors appears unlikely to produce clinically significant thrombocytopenia immediately after apheresis.
为评估献血频率低于每56天一次的正常志愿者献血者进行单采血小板时发生严重血小板减少的风险,并帮助了解影响这些献血者血小板采集量的因素,我们分析了607名献血者(405名男性,202名女性)916次单采血小板操作(使用Fenwal CS - 3000)前后的血小板计数(×10³/微升)及血小板采集量。献血前血小板计数平均值为265±59(标准差)(范围155 - 650)(男性256±55 [170 - 444];女性284±65 [155 - 650];P<0.001,t检验)。在平均采集血小板量为4.08×10¹¹后,血小板计数平均值为185±46(范围72 - 420)(男性184±42 [80 - 345];女性194±52 [72 - 500];P<0.1)。血小板计数的降低百分比(平均29.4±13,范围 - 28.1 - 65.5)与血小板采集量(P<0.01,r = 0.10)、献血前血小板计数(P<0.001,r = 0.29)及年龄(P<0.01,r = 0.10)呈正相关,与体重呈负相关(P<0.001,r = 0.18)。女性的降低百分比和血小板采集量均显著高于男性(P<0.001,t检验),且男女两性中,献血前血小板计数对血小板采集量的预测效果最佳(r = 0.65)。因此,单采血小板对献血者血小板计数的影响在不同献血者之间差异很大。虽然血小板计数降低超过50%并非罕见事件(占所有操作的5.9%),但仅有3例(0.3%)的实际献血后血小板计数低于100(72、94、95)。因此,正常献血者单采血小板后似乎不太可能立即出现具有临床意义的血小板减少。