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浓缩血小板输注——两种制剂的临床评估

Transfusion of platelet concentrates--clinical evaluation of two preparations.

作者信息

Strindberg J, Berlin G

机构信息

Department of Transfusion Medicine and Clinical Immunology, University Hospital, Linköping, Sweden.

出版信息

Eur J Haematol. 1996 Oct;57(4):307-11. doi: 10.1111/j.1600-0609.1996.tb01382.x.

Abstract

The aim of this study was to compare the clinical effect of transfusion of platelet concentrates (PC) prepared from pooled buffy coats (BC) and PCs collected from a single donor (SD) by an apheresis technique. The influence of storage time and various clinical conditions was also studied. Thirty-two patients suffering from haematological malignancies were given a total of 326 platelet concentrates; 180 BC-PCs and 146 SD-PCs, median 7 transfusions per patient. BC-PCs contained 312 +/- 52 x 10(9) and SD-PCs 383 +/- 133 x 10(9) platelets/unit (mean +/- SD). The mean storage time of BC-PC was 3 d and that of SD-PC 1 d. The mean platelet count of the patients before transfusion was 11 +/- 8 x 10(9)/L. Regression analysis showed a significant decrease of the post-transfusion platelet corrected count increment (CCI) during storage of PCs for 1-5 d (BC-PC: p < 0.01; SD-PC: p < 0.05). There was no difference in platelet increment between BC-PC and SD-PC. Human leukocyte antigen (HLA) alloimmunization was the major cause of clinical refractoriness to random donor platelet transfusions but splenomegaly also caused low CCI values.

摘要

本研究旨在比较由混合白膜层(BC)制备的血小板浓缩物(PC)与通过单采技术从单个供体(SD)采集的PC输血的临床效果。还研究了储存时间和各种临床状况的影响。32例血液系统恶性肿瘤患者共接受了326次血小板浓缩物输注;180次BC-PC输注和146次SD-PC输注,每位患者中位数为7次输血。BC-PC每单位含312±52×10⁹个血小板,SD-PC每单位含383±133×10⁹个血小板(均值±标准差)。BC-PC的平均储存时间为3天,SD-PC的平均储存时间为1天。患者输血前的平均血小板计数为11±8×10⁹/L。回归分析显示,在PC储存1 - 5天期间,输血后血小板校正计数增加值(CCI)显著下降(BC-PC:p < 0.01;SD-PC:p < 0.05)。BC-PC和SD-PC之间的血小板增加值无差异。人类白细胞抗原(HLA)同种免疫是随机供体血小板输血临床难治性的主要原因,但脾肿大也导致CCI值较低。

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