冰冻血小板和新鲜血小板临床输注效果的差异分析

Analysis on difference of clinical infusion effect of frozen platelet and fresh platelet

目的比较冰冻血小板和新鲜血小板用于治疗血液病及创伤性失血后患者在止血与血小板计数方面存在的差异。方法40例患者输注冰冻血小板,40例患者输注新鲜血小板。对血小板增高指数(CCI)和血小板回收率(PPR)、患者输注前后出血改善程度三方面进行评价。结果输注冰冻血小板1hCCI(5.8±1.4)×109、PPR36%,24hCCI(2.9±1.0)×109、PPR18%。输注新鲜血小板1hCCI(20.1±4.8)×109、PPR72%,24hCCI(16.0±6.1)×109、PPR56%。CCI值和PPR值比较,P<0.05,提示外周血小板计数差异有统计学意义。输注冰冻血小板组平均提高血小板计数能力不及输新鲜血小板组高,但两组输注后患者出血情况均有改善。结论在提高外周血小板计数方面两种制剂有差异,输新鲜血小板提升外周血小板计数效果好,输冰冻血小板效果差。评判冰冻血小板的效果,不以单纯外周血小板的计数指标评价,应综合评价。冰冻血小板只适用于应急止血,不适合常规使用,新鲜血小板是血液病患者的首选制剂。两种制剂在有效止血方面差异无统计学意义。

Objective To analyze the differences of stopping bleeding and platelet count between frozen platelet and fresh platelet in treating hematonosis and post traumatic bleeding. Methods 40 patients received frozen platelet infusion （frozen platelet group）, and the other 40 patients received fresh platelet infusion （fresh platelet group）. The differences of corrected count increment （CCI）, PPR（pereentage of platelet recovery）and the degree of hemorrhage amelioration after platelet infusion were compared between the two groups. Results CCI was （5.8± 1.4） ）〈 109 and （2.9±1.0） ×10^9 , PPR was 36% and 18% at 1 h and 24 h time-point respectively in frozen platelet group. By comparison, CCI was （20.1±4.8） ×10^9 and （16.0±6.1） ×10^9, PPR was 72% and 56% at 1 h and 24 h timepoint respectively in fresh platelet group. The differences of CCI, PPR and platelet count were significant between the two groups. The capacity of improving platelet count in frozen platelet group was inferior to that in fresh platelet group. However, the bleeding conditions in both groups were all ameliorated after platelet infusion. Conclusion There is difference of effect on improving peripheral blood platelet count between two biologieals. The blood platelet count after fresh platelet infusion is higher than that after frozen platelet infusion. The single blood platelet count is insufficient to evaluate effect of platelet infusion. Multi-indiee ought to be adopted eombinedly. Frozen platelet is only suitable for emergency treatment, and fresh platelet is the first choice %or hematologic disease. There is no significant differenee between the two biologieals.