血液病反复输血患者血小板抗体、交叉配型结果与血小板输注效果的相关性分析

目的探讨血液病反复输血患者血小板抗体、交叉配型试验结果与血小板输注效果的关系。方法回顾性分析112例血液病反复输血患者临床资料,根据入院时血小板抗体检验结果将其分为阳性组与阴性组,配型到阴性或弱阳性供者标本纳入相合亚组,多次配型均为阳性供者标本纳入不合亚组。比较阳性组与阴性组首次输注后,相合亚组与不合亚组本次输注后,1 h、24 h血小板校正增高计数(CCI)及血小板回收率(PPR)差异,采用Spearman相关系数模型分析1 h、24 h血小板CCI及PPR与血小板抗体检验、交叉配型试验结果的相关性。结果阳性组1 h CCI、24 h CCI、1 h PPR、24 h PPR水平均明显低于阴性组(P<0.05),相合亚组1 h CCI、24 h CCI、1 h PPR、24 h PPR水平均明显高于不合亚组(P<0.05)。血小板抗体测试结果与1 h CCI、24 h CCI、1 h PPR、24 h PPR水平均呈显著负相关(P<0.05);交叉配型试验结果与1 h CCI、24 h CCI、1 h PPR、24 h PPR水平均呈显著正相关(P<0.05)。结论血小板抗体检测及交叉配型结果与反复输血患者血小板输注效果关系较为密切,临床需积极开展上述试验以避免不必要的血小板资源浪费。

Correlation analysis of platelet antibody,cross matching and platelet transfusion in patients with hematopathy

Objective To explore the relationship between platelet antibody and cross-matching test results and platelet transfusion effects in patients with hemopathy and repeated blood transfusion.Methods The clinical data of 112 patients with hemopathy and repeated blood transfusions were retrospectively analyzed.According to the results of platelet antibody test at admission,they were divided into positive group and negative group.And the donor specimens matched as the negative or weak-positive were included in matching subgroup,and donor samples repeatedly matched as positive were included in mismatching subgroup.1 h and 24 h platelet corrected count increment(CCI)and platelet recovery(PPR)were compared between positive group and negative group after the first transfusion and between matching subgroup and mismatching subgroup after this transfusion.Spearman correlation coefficient model was used to analyze the correlation between1 h and 24 h platelet CCI and PPR and results of platelet antibody test and cross-matching test.Results The levels of 1 h CCI,24 h CCI,1 h PPR and 24 h PPR in positive group were significantly lower than those in negative group(P<0.05),and the levels of 1 h CCI,24 h CCI,1 h PPR and 24 h PPR in matching subgroup were significantly higher than those in mismatching subgroup(P<0.05).Platelet antibody test results were significantly negatively correlated with 1 h CCI,24 h CCI,1 h PPR and 24 h PPR(P<0.05).Cross-matching test results were significantly positively correlated with 1 h CCI,24 h CCI,1 h PPR and 24 h PPR(P<0.05).Conclusion The results of platelet antibody test and cross-matching are closely related to the platelet transfusion effects in patients with repeated blood transfusion.The above-mentioned tests should be actively carried out to avoid unnecessary waste of platelet resources in clinical application.