摘要
目的观察血液病患者输注机采血小板的治疗效果,探讨白细胞过滤及γ射线照射在预防血小板输注无效(PTR)中的作用。方法 759例患者每次输注机采血小板前1 h和输注后24 h检查靜脉血小板数量,计算血小板计数纠正增加指数(CCI),以输注后24 h CCI<4.5×109·L-1为PTR;发生PTR的患者,在再次输注血小板前,分别进行67例次的白细胞过滤和81例次的γ射线照射,其中,有26例次的血小板联合应用了这2项技术。结果 3 467例次输注新鲜机采血小板,无效率1 222/3 467,35.25%。免疫性血小板减少症(ITP)组的PTR发生率最高49.35%;机采血小板输注次数、累积剂量与输注效果比较,血小板量10 U,无效率26.2%;20 U,无效率51.72%;≥30 U,无效率73.58。20 U与10 U,≥30 U与10 U、20 U与≥30 U比较,χ2分别为38.56、106.46、14.29,P均<0.05。白细胞过滤、γ射线照射及γ射线照射联合白细胞过滤后的PTR发生率分别是19.51%(8/41)、20.00%(11/55)和3.85%(1/26),P均>0.05,但三者与未经治疗前患者的PTR发生率比较有显著差异(P<0.05)。结论 PTR的发生随患者疾病的不同而不同,ITP患者的PTR发生率最高;PTR的发生与患者血小板输注剂量有关,输注剂量越大,发生PTR的机率越大;白细胞过滤、γ射线照射等对预防PTR有明显效果。
Objective To investigate the role of leukocyte filtration and gamma irradiation in preventing platelet transfusion refractoriness（ PTR）. Methods In 759 patients with hematological diseases undergoing platelet transfusion,peripheral platelets were counted 1h before and 24 hrs after transfusion,The corrected count increments（ CCI） were calculated. When CCI were lower than 4. 5 × 10^9·L-1at 24 hrs after platelet transfusion,it was defined as PTR. Before the patients with PTR received platelet transfusion,machine-selected platelets were treated with leukocyte filtration and / or gamma irradiation.Results The highest rates of PTR was found in the immune thrombocytopenia（ ITP） group. The effectiveness of platelet transfusion was significantly influenced by the transfusion dose and times（ P 〈 0. 005）. The PTR rates were 19. 51%（ 8 /41）,20. 00%（ 11 /55） and 3. 85%（ 1 /26）,respectively,in leukocyte filtration group,gamma irradiation group and the group in which the platelets were treated with both methods. There was no statistical difference among them（ 0. 100 〈 P 〈0. 250）. However,they were significantly lower than the untreated group（ P 〈 0. 005）. Conclusion PTR rates are distinctly different among the hematologic disease groups,and the ITP group has the highest PTR rate. PTR rate is significantly influenced by the dose and frequency of platelet transfusion. Leukocyte filtration and gamma irradiation are efficient in preventing PTR.
出处
《中国输血杂志》
CAS
北大核心
2016年第7期713-715,共3页
Chinese Journal of Blood Transfusion
基金
淮安市科技局基金(HAS06037
HAS2009009)
关键词
血小板输注
血小板输注无效
白细胞过滤
Γ射线照射
platelet transfusion
platelet transfusion refractoriness
leukocyte filtration
gamma irradiation
