AB型血小板次侧相容性输注对同型血小板输注疗效的影响

Effect of AB platelet secondary compatible transfusion on the efficacy of matched platelet transfusion

目的探索AB型单采血小板次侧相容性输注后,对后期患者同型血小板输注疗效的影响。方法收集2020年11月至2021年9月本院血小板输注2276人次,其中ABO同型血小板输注2068人次,AB型次侧相容性输注206人次,选出第1次AB次侧相容性输注117人次,AB次侧相容性输注前同型血小板输注为对照组,AB型次侧相容性输注后同型血小板输注为试验组(第1次输注为第1组,第2次为第2组,第3次为第3组),以血小板输注前、后患者血小板计数(Plt)、血小板增高值(△Plt)以及24 h Plt纠正增加指数(CCI)为观测指标,按性别、血型和病种分析AB型次侧相容的非同型血小板输注对后期同型血小板预防性输注疗效的影响。结果2276人次血小板输注,同型血小板输注△Plt明显高于AB型次侧相容性输注,其平均值分别为(14±15)×10^(9)/L、(11±14)×10^(9)/L,P<0.05;女性患者输注血小板后△Plt高于男性患者,分别为(15±16)×10^(9)/L、(13±14)×10^(9)/L,P<0.05;病种MDS、NHL和MM血小板输注疗效差于其它病种,△Plt(9±14、10±12、8±11)×10^(9)/L,明显低于平均值(P<0.05)。117例AB型次侧相容性输注:AB型次侧相容性血小板输注后△Plt明显低于对照组和试验组,分别为(9±12)×10^(9)/L、(13±13)×10^(9)/L、(13±12)×10^(9)/L,P<0.05;24 h CCI有效率为52.14%明显低于对照组(71.59%)、试验组(71.83%),P<0.05。试验组与对照组△Plt、24 h CCI有效例数均差异不明显,P>0.05。试验组第3组△Plt(10±13)×10^(9)/L相较于第1组(14±12)×10^(9)/L明显有所降低,P<0.05,有效输注率也有所下降,由73.12%(68/93)降至58.70%(27/46),P>0.05。试验组和对照组分别从性别、血型、病种三方面因数进行对比,△Plt、24 h CCI有效例数均差异不明显,P>0.05。结论AB型次侧相容性血小板输注△Plt和有效率低于同型血小板输注,对患者短期(10 d)内的同型血小板输注影响不明显。

Objective To retrospectively analyze the effect of AB platelet secondary compatible transfusion on the effica⁃cy of matched platelet transfusion.Methods A total of 2276 cases of platelet transfusion in our hospital were selected from November 2020 to September 2021,including 2068 ABO matched platelet transfusions and 206 AB platelet secondary com⁃patible transfusions.117 cases were selected for the first occasion of AB platelet secondary compatible transfusion.The con⁃trols were matched transfusion receipts before given AB platelet secondary compatible transfusion,and the experimental group was given matched transfusion after AB platelet secondary compatible transfusion(take the first,second and third transfusion as group 1,2 and 3,respectively).The platelet count(Plt),platelet elevation(△Plt)and 24 h Plt correction increase in⁃dex(CCI)of patients before and after platelet transfusion were used as observation indexes to analyze the effect of AB type mis⁃matched platelet transfusion on the efficacy of matched platelet preventive transfusion by gender,blood type and disease type.Results Among the 2276 platelet transfusions,and the△Plt of matched platelet transfusions was significantly higher than that of AB type secondary compatible transfusions,with the mean values at(14±15)×10^(9)/L and(11±14)×10^(9)/L(P<0.05).The△Plt of female patients was higher than that of male patients(15±16)×10^(9)/L vs(13±14)×10^(9)/L(P<0.05).The△Plt values of MDS,NHL and MM were(9±14)×10^(9)/L,(10±12)×10^(9)/L and(8±11)×10^(9)/L,respectively,which were significantly lower than the average value(P<0.05).For 117 cases of AB platelet secondary compatible transfu⁃sion:theΔPlt was significantly lower than that of the control group and the experimental group,respectively at(9±12)×10^(9)/L,(13±13)×10^(9)/L and(13±12)×10^(9)/L(P<0.05).The effective rate of 24 h CCI was 52.14%,significantly lower than the control group and experimental group(71.59%vs 71.83%),P<0.05;no significant difference was noticed in△Plt value and 24 h CCI between the experimental group and the control group(P>0.05).The△Plt of the experimental group 3 was significantly lower compared with the experimental group 1,(10±13)×10^(9)/L vs(14±12)×10^(9)/L,P<0.05,and the effective rate decreased from 73.12%(68/93)to 58.70%(27/46),P>0.05.No significant difference in△Plt and the number of effective 24 h CCI cases was found between the experimental group and the control group in terms of gender,blood type and disease type(P>0.05).Conclusion The△Plt and the effective rate of AB platelet secondary compatible transfusion were lower than those of matched platelet transfusions,and has no significant effect on short term(less than 10 days)matched platelet transfusion.