单采和手工血小板治疗效果的Meta分析

Therapeutic Effect of Pheresis Platelets and Platelet Concentrate:a Meta-Analysis

目的应用Meta分析方法系统评价单采和手工血小板在临床输血治疗中提升血小板的疗效。方法计算机检索CBM、CNKI、VIP、万方等数据库。收集应用单采和手工血小板在临床输血治疗中提升血小板的随机和半随机对照试验,采用Review manager5.0软件对资料进行Meta分析。结果共纳入4个研究,1 008例患者。Meta分析结果显示,与输注手工血小板组相比,单采血小板组血小板计数增加校正指数(CCI)明显升高(WMD=5.46,95%CI:2.75～8.17,P<0.01);实际血小板回收率(PPR)亦提高(WMD=14.17,95%CI:7.75～20.59,P=0.05);输血反应发生率也较低(RR=0.28,95%CI:0.16～0.48,P<0.01)。结论输注单采血小板制剂能更有效地提高患者的血小板值,临床止血效果优于输注手工血小板制剂,并减少其血小板输注无效及输血反应的发生。

Objective To evaluate the effect of pheresis platelets and platelet concentrate on elevating platelets in clinical transfusion by meta-analysis.Methods We searched for randomized controlled trials（RCTs） and quasi-RCTs in the following electronic databases： CBM,CNKI,VIP,and WanFang. All data were analyzed by Review manager 5.0.Results Four studies involving a total of 1 008 participants met the inclusion criteria.The outcomes of meta-analysis implied that：compared with platelet concentrate transfusion,pheresis platelets transfusion could improve the effect of clinical hemostasis effect（hazard ratios,HR=1.07,95%CI：0.93～1.23,P=0.35）,platelet count increase correct index,CCI（WMD=5.46,95%CI：2.75～8.17,P〈0.01） and practical platelet reclaim ratio,PPR（WMD=14.17,95%CI：7.75～20.59,P=0.05）.And transfusion reaction ratio decreased（RR=0.28,95%CI：0.16～0.48,P〈0.01）.Conclusion Pheresis platelets transfusion can improve the effect of clinical hemostasis,PPR and CCI.Furthermore,it also reduce transfusion reaction ratio.