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血小板压积和绝对未成熟血小板计数不受血小板输注的影响:一项单中心前瞻性研究。

Plateletcrit and absolute immature platelet count are not impacted by platelet transfusions: a single-centre prospective study.

机构信息

Department of Haematology, The Royal London Hospital, London, UK.

出版信息

Scand J Clin Lab Invest. 2024 Sep;84(5):317-325. doi: 10.1080/00365513.2024.2392127. Epub 2024 Aug 14.

Abstract

BACKGROUND

This is the first study in which the impact of platelet transfusions on seven platelet indices was evaluated in platelet transfusion-dependent patients admitted in the ICU.

STUDY DESIGN AND METHODS

Among a cohort of 21 ICU patients prospectively studied over eleven months, a total of 19 ICU patients were enrolled. Seven platelet indices were measured before and then, within 18-24 h, after platelet transfusions using the Sysmex XN-10 analyser and statistically investigated as follows: i) apheresis vs. pooled platelet transfusions; ii) pre- vs. post-platelet transfusions; and iii) platelet count (PC) increment vs. PC decrement group.

RESULTS

A 79.2% of platelet transfusion episodes in ICU patients showed an increase in PC increment within 18-24 h, of which 73.7% had a peak percentage immature platelet fraction (%-IPF) above 10.0% during their stay. No difference was observed in the measurements of platelet indices between the apheresis and pooled platelet transfusion doses (all  > 0.05). Of the seven platelet indices investigated, plateletcrit (PCT) and absolute immature platelet count (A-IPF) were not influenced by platelet transfusions and thus proven to be stable (0.06 vs. 0.07%,  = 0.0901 and 4.6 vs. 4.9 × 10/L,  = 0.4559, respectively), despite their close proximity to platelet transfusion. But the overall effectiveness of these indices in detecting changes over time was not hindered.

CONCLUSION

A-IPF and PCT are stable after platelet transfusions, regardless of whether patient's respond to or do not respond to platelet transfusion doses. PCT and A-IPF may thus prove useful in monitoring patient transfusion support and guiding management in thrombocytopenic patients.

摘要

背景

这是第一项研究,评估了在 ICU 住院的血小板依赖患者中血小板输注对七个血小板指标的影响。

研究设计和方法

在一项为期十一个月的前瞻性研究中,共纳入了 21 名 ICU 患者,其中共有 19 名患者入组。使用 Sysmex XN-10 分析仪在血小板输注前和输注后 18-24 小时内测量了七个血小板指标,并进行了以下统计学研究:i)单采 vs. 混合血小板输注;ii)输注前 vs. 输注后;iii)血小板计数(PC)增加 vs. PC 减少组。

结果

ICU 患者血小板输注的 79.2%在 18-24 小时内表现为 PC 增加,其中 73.7%在住院期间峰值未成熟血小板分数(%-IPF)超过 10.0%。在单采和混合血小板输注剂量之间,血小板指数的测量没有差异(均>0.05)。在所研究的七个血小板指标中,血小板压积(PCT)和绝对未成熟血小板计数(A-IPF)不受血小板输注的影响,因此被证明是稳定的(0.06 vs. 0.07%,=0.0901 和 4.6 vs. 4.9×10/L,=0.4559,分别),尽管它们与血小板输注密切相关。但这些指标在检测随时间变化方面的整体有效性并未受到影响。

结论

无论患者对血小板输注剂量是否有反应,血小板输注后 A-IPF 和 PCT 均保持稳定。因此,PCT 和 A-IPF 可能在监测患者输血支持和指导血小板减少患者的管理方面具有一定的应用价值。

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