单采血小板输注的临床疗效观察

目的 通过观察单采血小板输注的临床疗效,为科学、合理、有效使用血小板提供参考依据.方法 对171例(447例次)输注血小板患者按不同疾病和输注频率分组进行统计分柝,计数输注前、输注后1h、24 h外周血小板,计算血小板计数增高指数(CCI)、血小板回收率(PPR)等指标来判断临床疗效.结果 (1)血液病患者输注血小板有效率明显低于外科手术、肿瘤及其他疾病患者,差异具有统计学意义(P＜0.01).(2)低频组血小板输注有效率高于中频组和高频组,差异有统计学意义(P＜0.01)；中频组与输注7次以上的高频组比较,差异有统计学意义(P＜0.01).(3)低频组与中频组、高频组,中频组与高频组的输注后1h、24 h CCI和PPR比较差异有统计学意义(P＜0.01).结论 不同疾病血小板输注的疗效不同.随着输注频率的增加,血小板输注有效率逐渐下降,频繁输注者(≥7次)输注疗效较差,易出现血小板输注无效(PTR).

Observation and Analysis on the Curative Effect of Apheresis PLT Transfusion

Objective To provide evidence for the scientific, reasonable and effective clinical use of platelet through observaing the clinical curative effect of apheresis platelets transfusion. Methods Statistical analysis were carried out for 171 platelet transfused patients according to different diseases and transfusion frequency, the peripheral platelets were counted before transfusion and 1 h, 24 h after transfusion, the clinical effects were evaluated according to the corrected count increment（CCI）, percentage platelet recovery（PPR） and other variables. Results （1） The platelet transfusion effi- ciency in patients with hematologic diseases was lower than those suffered from surgical operations, tumors and other dis- eases. There was statistical significance in the difference （P〈0. 01）. （2） Platelet transfusion efficiency of low frequency groups was higher than intermediate frequency and high frequency groups, the differences had statistical significances （P〈 0. 01）. The difference between intermediate frequency groups and high frequency groups which were transfused more than 7 times was of statistical significance （P〈0. 01）. （3） The differences of CCI and PPR 1 h and 24 h after the transfusion a- mong the three groups of low, intermediate and high frequency were of statistical significances （P〈0.01）. Conclusion The curative effect of platelet transfusion is different in different diseases. With the increase of transfusion frequency, platelet transfusion efficiency decreases gradually. The transfusion efficiency in frequent transfusion patients （≥7） is low, and even appears platelet transfusion refractoriness （PTR）.