活化血浆凝固时间在预防性血小板输注中的应用

目的探讨活化血浆凝固时间（APCT）在预防性血小板输注中的应用价值。方法根据患者有无出血表现，将150例血小板计数〈50×10^9／L的患者分为两组，其中出血组42例，未出血组108例。抽取患者的静脉血，枸橼酸钠抗凝，进行血小板计数（PLT）和APCT测定。结果出血组和未出血组的PLT和APCT分别为（9±4）×10^9／L、（102±7）s，（24±11）×10^9／L、（68±9）S，两者比较差异均有统计学意义（P均〈0．01），提示出血的敏感性和特异性，APCT远高于PLT；以APCT≥92s作为血小板输注的界点值，可有效预防由血小板减低引起的出血。结论APCT是血小板预防性输注的良好指征，预防性血小板输注的阂值确定为APCT≥92S是安全有效的。

Evaluation of activated plasma clotting time test on prophylactic platelet transfusions

Objective To investigate the clinical values of activated plasma clotting time test （APCT） on prophylactic platelet transfusions. Methods One hundred and fifty patients with platelet couts〈 50 × 10^9/L,42 of 150 patients with bleeding symptoms （petechiae, epistaxis）and 108 patients without, were involved in the test. Draw their venous blood and collected in sodium citrate, the platelet count and APCT test were performed. Results APCT in bleeding group was obviously prolonged contrast to the non - bleeding group＇ s. Platelet count and APCT of the bleeding group and the non - bleeding group were （9 ± 4） × 10^9/L, （ 102 ± 7 ） s and （24 ± 11 ） × 10^9/L, （68 ± 9 ） s, respectively. There were statistically significant differences between the two groups （ P 〈0.01 ）. The APCT was better than PLT for predicting the bleeding due to thrombocytopenia. Using APCT≥92 s as the cut -off point for prophylactic platelet transfusion would accurately predict major bleeding due to thrombocytopenia. Conclusions APCT is a good predictor of prophylactic platelet transfusion. APCT≥92 s as trigger is safety and less cost.