丙种反应性蛋白与血小板输注疗效的关系

RELATIONSHIP BETWEEN THE THERAPY EFFECTS OF PLATELETS CONCENTRATES TRANSFUSION AND C-REACTIVE PROTEIN

目的探讨恶性血液病及实体瘤化疗后血小板减少并出血病人输注浓缩血小板的疗效与丙种反应性蛋白之间的关系. 方法观察46例恶性血液病及13例实体瘤化疗后血小板减少并出血病人,共输注浓缩血小板113次,在输注前、输注后12～16 h外周血小板计数、临床出血情况,分析丙种反应性蛋白(C-reactive protein, CRP)指标改变对输血小板效果的影响,全部59例被分为CRP正常组和CRP增高组. 结果输注浓缩血小板后,外周血小板计数升高值:CRP增高组(12.16±8.27)×109/L较CRP正常组(28.65±10.34)×109/L低(P<0.01).实体瘤组输血小板前后差值(29.44±11.07)×109/L较恶性血液病组(17.32±11.33)×109/L高(P<0.05),治疗3天后临床出血改善率79%. 结论输注浓缩血小板,能提高外周血小板计数,临床止血效果明显,可防止或减少脑出血等严重事件的发生.CRP可能是影响血小板输注效果的又一因素.

Objective To study the relationship between therapy effects of platelets concentrates (PC) transfusion and C-reactive protein (CRP) in thrombocytopenia and bleeding of hematological malignancies and solid tumor chemotherapy. Methods To observe peripheral blood platelets count, clinical hemostasis and CRP before and 12～16 hrs after PC transfusion on 46 hematological malignancies and 13 solid tumor chemotherapy, and analyze the relationship between effects of PC transfusion and serum levels of CRP in hematological malignancies and solid tumor chemotherapy. All cases were divided into CRP increase group and CRP normal one. Result Increasing peripheral blood platelets count(12.16±8.27)×10 9/L after PC transfusions in CRP increase group are lower than that count(28.65±10.34)×10 9/L in CRP normal group ( P <0.001). The count increasing valuation after PC transfusion is (29.44±11.07)×10 9/L in solid tumor chemotherapy; and (17.32±11.33)×10 9/L in hematological malignancies, there are significant difference between them ( P <0.05). Clinical hemostasis rates 3 days after the transfusions are 79%(89/113). Conclusions PC transfusion can increase the levels of peripheral blood platelets count, and clinical hemostasis rates, in order to prevent and reduce major bleeding events such as strokes. CRP is another affect factor of PC transfusion.