活化血浆凝固时间对血小板输注疗效评价的研究

Test of Activated Plasma Clotting Time to Assess Efficacy of Platelet Transfusion

本研究探讨活化血浆凝固时间(APCT)对评价血小板输注疗效的价值,用血小板聚集凝血因子分析仪检测了20例血液病患者血小板输注前后APCT的变化,并与血小板计数增加校正指数(CCI)和实际血小板回收率(PPR)进行了对比研究。结果表明:输注1小时、24小时后的APCT均明显缩短,APCT由血小板输注前的(103.7±11.3)秒分别缩短为输注后1小时、24小时的(60.0±9.7)秒、(68.5±9.8)秒,(P<0.01),而正常对照的APCT为(42.0±3.4)秒;按照CCI和PPR的判断标准(输注后1小时和24小时CCI分别为<7500和<5000,PPR分别为<30%和20%为输注无效),有2例为血小板输注无效,其输注1小时、24小时的CCI值分别为7415、2966和6913、4988,PPR值分别为28.0%、11.2%和25.2%、14.1%。1例PPR均达血小板输注无效标准,而CCI值均显示血小板输注有效;2例PPR均达血小板输注无效标准,而输注1小时的CCI值表示为血小板输注有效,24小时的CCI值表示为血小板输注无效。结论:APCT可以反映血小板数量和质量的变化,也能较全面的评估血小板的输注疗效。

The study was aimed to investigate the value of activated plasma clotting time （APCT） for estimating the efficacy of platelet transfusion therapy. There were twenty patients with hematological diseases, who received transfusion of platelet, involved in the test. APCT was determined before and after transfusion of these patients, then APCT was contrasted with corresponding CCI and PPR. The results showed that 1 hour and 24 hour APCTs were shortened obviously. APCT before transfusion was （ 103.7 ± 11.3 ） seconds, but the 1 hour and 24 hour APCTs were shortened to （ 60.0 ± 9.7 ） seconds and （ 68.5 ± 9.8） seconds respectively （ P 〈 0. 01 ）. According to the judging criteria of CCI and PPR （CCI and PPR values at 1 and 24 hours after transfusion are 〈 7500, 〈 5000 and 〈 30%, 〈 20% respectively, the transfusion is invalid）, two patients received invalid transfusion. Their 1 and 24 hour CCIs were 7415,2966 and 6913, 4988 respectively. Their 1 and 24 hour PPRs were 28.0%, 11.2% and 25.2%, 14.1% respectively. One patients PPR reached the standard of invalid transfusion, but his CCI showed a valid transfusion he received. Two patients＇ PPR reached the standard of invalid transfusion, but their 1 hour CCI reached the standard of valid transfusion, and their 24 hour CCI reached the standard of invalid transfusion. It is concluded that APCT reflects the variations of quantity and quality of platelet simultaneously, and can evaluate precisely the efficacy of platelet transfusion.