急性白血病患者血小板无效输注的原因分析

Analysis of platelet transfusion refractoriness in patients with acute leukemia

目的:探讨急性白血病(AL)血小板输注无效的原因。方法:观察106例AL患者的263例次单采血小板输注效果并检测血小板抗体,分析讨论血小板无效输注的影响因素。结果:①AL血小板无效输注率为43.35%;②血小板抗体阳性检出率为32.32%;③血小板输注有效组与无效组的抗体阳性检出率的差异有统计学意义(P<0.01)。④AL发热组输注无效率高于未发热组(P<0.01);脾脏肿大与无肿大组无效输注率差异有统计学意义(P<0.01)。结论:引起血小板输注无效的病因复杂。血小板输注前应进行血小板抗体的筛选,避免或减少造成血小板输注无效的原因,提高血小板输注的有效率。

Objective：To investigate the reasons of platelet transfusion refractoriness （PTR） in patients with a cute leukemia. Method： The effects of platelet transfusion in patients with acute leukemia were observed, and antiplatelet antibodies were detected using simplified sensitized erythrocyte platelet serology assay（SEPSA）, then the influencing factors of PTR were analyzed. Result： ①The PTR rate was 43.35% in acute leukemia patients.②The positive rate of platelet antibodies was 32.32% ③There was a significant difference in the antibody positive rate between the efficient group and inefficient group （P〈0.01）. ④For the patients with acute leukemia, the inefficient rate of fever group was higher than that of non-fever group （P〈0.01）. There was a significant difference in inefficient transfusion rate between splenomegaly group and non-splenomegaly group （P〈0.01）. Conclusion：Many factors can induce PTR. Doctors should avoid or decrease all induction factors so as to increase the efficiency of platelet transfusion.