影响血小板输注疗效的多因素分析

目的探讨输注血小板的疗效,分析影响疗效的各因素。方法以计算纠正的血小板增值(CCI)作为判定血小板无效输注(PTR)的指标,研究57例患者102例次输注血小板的疗效。将发热(X1)、脾大(X2)、用抗生素(X3)、出血表现(X4)、反复输注血小板(X5)、病种是否和免疫因素有关(X6)、化疗中(X7)、血小板相关抗体(X8)列入备选因素,使用Logistic回归对这些可能影响输注疗效的原因进行多因素分析。对怀疑免疫因素引起的病例检测血小板相关抗体(PAIg),血小板抗体(主要包括血小板特异抗原,HLA抗原和ABH抗原物质,这些抗原物质所刺激产生的抗体)。结果按输注后1小时CCI计算,PTR发生率56.86%。血小板相关抗体检出率43.56%。在反复输注的40例病人中血小板抗体检出率45%。在回归分析中X2,X4,X5,X8入选成为影响血小板输注疗效的独立风险因素。结论血小板输注的疗效受多种因素影响,提高疗效最好的方法是避免或减少这些因素的发生。

Multi-influencing factor analysis on curative effect with platelet transfusion

Objective To study the influencing factor of curative effect with platelet transfusion.Methods The curative effects of 102 times platelet transfusion for 57 patients were studied by calculating modified platelet corrected count increament(CCI)as benchmark judging ineffective platelet transfusion,The factors,inluding fever(X1),spleen enlargement(X2),using antibiotic(X3),bleeding state(X4),repeated transfusion(X5),diseases with immuization(X6),chemotherapy(X7),platelet correlation antibody(X8),were analyzed by binary Logistic Regression with SPSS 10.0.Platelet correlation antibodies were tested for those cases seemingly related to immune factor.Results The ratio of ineffective platelet transfusion was 56.86% based on the calculation of CCI after 1 hour transfusion;The positive ratio of platelet antibodies was 43.56%.with 45% of repeated transfusion in 40 cases.Above factors of X2,X4,X5,X8 showed influencing the curative effect of platelet transfusion respectively.Conclusions The curative effect of platelet transfusion can be influenced by several factors,so it is necessary to avoid their occurrence.