血小板输注对再生障碍性贫血的疗效及其影响因素分析

目的 探讨再生障碍性贫血患者进行血小板输注的疗效,分析影响其疗效的因素.方法 选择2019-01/2020-07月作者医院再生障碍性贫血输血有效患者57例作为有效组,另选择同时段输血无效患者57例作为无效组,对入组患者均进行血小板输注治疗.对比分析两组患者接受血小板输注前后的血小板回收率(percentage platelet recovery,PPR)、血小板计数增高指数(corrected count increment,CCI),再对患者的性别、年龄、合并感染情况等因素进行统计,并对影响血小板输注疗效的相关因素进行分析.结果 有效组患者接受血小板输注后1、24 h的PPR、CCI均显著高于无效组(P＜0.05);有效组患者输血不良反应发生率明显低于无效组(3.51％vs.14.04％,P＜0.05).有效组活动性出血发生率、感染发生率、输血反应发生率均低于无效组(P＜0.05),有效组细菌培养阳性率高于无效组(P＜0.05);两组患者性别、年龄、输血次数、输注其他红细胞、输血不良反应差异无统计学意义(P＞0.05).经Logistic回归分析显示:活动性出血、细菌培养阳性是影响再生障碍性贫血患者进行血小板输注疗效的危险因素(P＞0.05).结论 再生障碍性贫血患者通过血小板输注能获得一定治疗效果,其中合并活动性出血、细菌培养阳性患者治疗效果欠佳,临床可通过加强对上述患者干预进一步改善血小板输注效果.     

血液病患者血小板输注效果评价及影响因素分析

目的探讨血小板输注在防治血液病患者出血中的有效性及其影响因素。方法对68例反复输血治疗的血液病患者给予机采血小板输注,输注后24h进行外周血血小板计数,根据血小板回收率(PPR)和血小板增高指数(CCI)判定输注效果并讨论其影响因素。结果(1)急性白血病(AL)、再生障碍性贫血(AA)、特发性血小板减少性紫癜(ITP)和骨髓异常增生综合征(MDS)患者血小板输注有效率分别为88·9%(153/172)、83·1%(59/71)、51·3%(19/37)和68·8%(11/16),4种类型的血液病患者血小板输注有效率间差别有显著性意义(P<0·05);(2)AL、AA、ITP无并发症患者血小板输注有效率与同病种有并发症患者比较,差别有显著性意义(P<0·05);(3)无并发症组患者血小板输注有效率随输注次数的增加而下降(P<0·05),而有并发症组患者血小板输注有效率与输注次数关系不大(P>0·05)。结论输注血小板是预防和治疗因血小板减少或血小板功能障碍而引起的出血的最有效措施,输注次数、发热、脾肿大、弥散性血管内凝血(DIC)等因素影响血小板的输注效果。     

单个供者血小板悬液输注的临床观察

为了解单个供者血小板悬液(SD-PC)治疗严重血小板减少症的疗效,通过对输注后血小板增校值(CCI)的观察,比较不同血液系统疾病及其时期对输注的反应,分析血小板输注无效(RPT)的发生率以及有关影响因素。结果显示:急性白血病诱导缓解期、骨髓增生异常综合征(MDS-RAEB)的CCI低于再生障碍性贫血(P<0.01、0.05);急性白血病诱导缓解期CCI低于缓解期(P<0.01),首次输注血小板者疗效优于末次(P=0.05)。     

血液病患者血小板输注治疗的效果及影响因素logistic回归分析

目的研究血液病患者血小板输注治疗的效果并对影响因素进行logistic回归性分析。方法回顾性分析我院2013年11月至2015年11月63例血液病患者的临床资料,两组患者均予以血小板输注治疗,比较患者血小板输注前后血小板计数变化以及不同类型血液病患者血小板输注有效率,分析影响血小板输注的相关因素并进行Logistic单因素回归分析。结果输注后血小板计数较输注前显著较高(P0.05);急性白血病患者、再生障碍性贫血患者血小板输注有效率分别为87.13%、83.02%较特发性血小板减少性紫癜、骨髓异常增生综合征51.28%、67.86%显著较高(P0.05);反复输血次数≥3次、发生感染、脾肿大、活动性出血患者血小板输注无效率分别为68%、36%、70%、12%较血小板输注有效率30.41%、19.88%、36.26%、4.68%显著较高(P0.05)。结论反复输注血小板、感染、脾肿大、活动性出血是血小板输注无效的影响因素。     

小儿造血系统疾病细小病毒B19感染

0　引言　人细小病毒 B19(Human parvovirus B19,B19) ,与人类造血系统疾病关系最为密切 [1 ] .为探讨我国血液病患儿B19病毒感染状况 ,我们对儿童常见血液病患者血清进行B19抗体及 B19- DNA检测 .1　对象和方法1.1　对象　病例组 75例 ,为 1999- 0 2 / 1999- 10在我院儿科及血液科住院的病因不明的血液病患者 ,包括再生障碍性贫血18例 (急性再生障碍性贫血 15例 ,纯红细胞再生障碍性贫血3例 ) ,急性特发性血小板减少性紫癜 (ITP) 2 1例 ,急性白血病2 3例 (急性淋巴细胞白血病 17例 ,急性粒细胞白血病 5例 ,急性单核细胞白血病 1例 ) …     

机采和手工血小板治疗效果的临床分析

目的探讨机采血小板和手工采集血小板治疗再生障碍性贫血的临床效果。方法选择2009年10月—2012年10月期间该院收治的再生障碍性贫血患者共32例,按分层随机原则分为机采组(16例)和手工组(16例),分别采用机采血小板和手工采集血小板进行治疗,测量治疗前以及输注后1h和24h的外周血小板并计算CCI和PPR。结果机采组血小板输注后1h和24hCCI均高于手工组(P<0.05),机采组的1h和24hPPR均高于手工组(P<0.05)。手工组共5例发生不良反应,发生率为31.25%,机采组共1例发生不良反应,发生率为6.25%,经检验,机采组的不良反应发生率明显低于手工组(P<0.05)。结论机采血小板的治疗效果优于手工采集的血小板。     

血小板抗体对血小板输注效果的评价

目的探讨血小板相关抗体与血小板输注效果的关系。方法采取ELISA法分别对51例输血患者检测血小板相关抗体。在血小板输注前后计数血小板、并计算1h和24h血小板增值(CCI)。结果51例血液病患者检出血小板抗体阳性26例,占50.98%,1h和24h抗体阳性组(CCI值)明显低于抗体阴性组(P<0.01)。输注无效率抗体阳性组为80.77%,抗体阴性组为20.00%,两组比较差异有显著性(P<0.01)。结论血小板输注效果与免疫和非免疫等多种因素有关。血小板抗体阳性的患者,并不一定会发生血小板输注无效,再进行血小板交叉配血试验,有助于减少同种免疫反应。     

血小板输注在肿瘤化疗中的应用

目的 :探讨肿瘤化疗患者血小板输注效果及影响因素。方法 :对 5 8例在化疗后出现严重血小板减少的恶性肿瘤患者 ,输注单采或多人份混合血小板悬液 ,并于输注前及输注后 1 h和 2 4 h后检测血小板计数 ,以校正血小板计数增值 ( CCI) ,判定输注效果并讨论其影响因素。结果 :单采组 CCI显著高于混合组 ;单采组及混合组输注有效率分别为 93.3%和 89.1 % ;感染组血小板及非感染组无效输注率 ( PTR)分别为 43.7%和 6.9% ,差异十分显著 ;单采组及混合组中不良反应发生率分别为 2 .4%和 6.3% ,差异十分显著。结论 :血小板输注是治疗因血小板减少导致出血的有效措施 ,单采血小板疗效更好 ,但是感染是影响血小板输注效果的一个重要因素     

血小板输注的临床应用

目的：通过输注血小板提高血小板数以达到迅速止血作用。方法：选人急性白血病、再生障碍性贫血、手术大输血病人进行血小板输注一个治疗量，1次／d对输注前后病人血小板计数进行观察。结果：输注后1h左右出血止住，急性白血病和再生障碍性贫血病人有效率为78．6％，手术大输血有效率为100％。本组18例输注前后血小板含量差异显著性（P〈0．01）。结论：采用血小板输注是有效提高血小板数，迅速达到止血的方法之一。     

血液病患者血小板输注效果评价及其影响因素探讨

目的探讨血液病患者血小板输注的有效率及其影响因素。方法对79例血液病患者给予输注机采血小板共322例次,输注后18～24小时进行外周血血小板计数,根据血小板回收率(PPR)和血小板计数增高指数(CCI)评价血小板输注效果,并探讨其影响因素。结果急性白血病(AL)、再生障碍性贫血(AA)、特发性血小板减少性紫癜(ITP)和骨髓增生异常综合征(MDS)患者血小板输注有效率分别为74.39%、71.86%、50.54%和63.64%(P<0.01)。AL、MDS组中发热患者血小板输注有效率低于未发热患者(分别为P<0.01和P<0.05)。AL、MDS组中脾脏肿大患者血小板输注有效率低于脾脏不肿大患者(P<0.01)。AL患者是否发生弥漫性血管内凝血(DIC)血小板输注有效率有显著差别(P<0.05)。无并发症组患者血小板输注有效率随输注次数的增加而下降(P<0.01),而有并发症组患者血小板输注有效率与输注次数关系不大(P>0.05)。结论输注血小板是预防和治疗因血小板减少或血小板功能障碍而引起的出血的最有效的措施。引起血小板输注无效的病因复杂,发热、脾肿大、DIC、输注次数等是影响血小板输注效果的重要因素。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.