输注白细胞滤过的血小板预防发热性非溶血性输血反应的Meta分析

Prevention of Febrile Non-Hemolytic Transfusion Reaction to Leukocyte-Filtered Platelet Transfusion： A Meta- Analysis

目的系统评价患者输注白细胞滤过的血小板（PLT）与普通PLT预防发热性非溶血性输血反应（FNHTR）的效果。方法计算机检索PubMed，Embase，Cochrane图书馆和中国生物医学文献数据库，检索年限从建库至2010年12月。纳入白细胞滤过PLT与普通PLT比较预防FNHTR的随机对照试验。采用RevMan5．0软件进行Meta分析。结果共纳入12篇文献。Meta分析结果显示：输注白细胞滤过的PLT发生FNHTR的风险仅为普通PLT的56％ERR=0．56，95％CI（0．39，0．82），P=0．0031。PLT保存前和保存后滤过白细胞对于FNHTR发生率的影响比较，差异无统计学意义[RR=0．41，95％CI（0．15，1．14），P=0．091。结论与输注普通PLT相比，输注白细胞过滤的PLT可降低FNHTR的发生率，但白细胞滤过时机对FNHTR的发生率无显著影响。

Objective To systematically assess the effect of leukocyte-filtered platelet（PLT） and PLT concentrates transfusion on preventing febrile non-haemolytic transfusion reaction （FNHTR）. Methods Such databases as PubMed, EMBASE, the Cochrane Library and CBM were searched from their establishment to December 2010. Randomized controlled trials were included. The Meta-analysis was conducted by Cochrane Collaboration＇s RevMan 5.0 software. Results 12 studies were selected to further Meta-analyses. The data showed that leukocyte-filtered PLT transfusion significantly decreased FNHTR [RR=0. 56,95%CI （0. 39, 0. 82）, P%0. 00011 compared to PLT concentrates. Pre-storage leukocytefiltered PLT transfusion had no significant difference of FNHTR compared to post-storage leukocyte-filtered PLT transfusion [RR = 0. 41,95 M CI （0. 15, 1. 14）, P = 0. 091. Conclusions Leukocyte-filtered PLT transfusion could prevent FNHTR more effectively than PLT concentrates independent on filtering time.