活化血浆凝固时间对血小板预防性输注及疗效评价

Evaluation of activated plasma clotting time test on prophylactic platelet transfusions

目的分析活化血浆凝固时间(APCT)在预防性血小板输注中的应用价值。方法将100例血小板计数<50×109/L的患者根据有无出血表现,分为出血组(29例)和未出血组(71例)。所有患者均抽取静脉血进行血小板计数(PLT)和APCT测定。结果两组PLT和APCT比较差异有统计学意义(P<0.05),说明APCT出血的敏感性和特异性高于PLT;以APCT≥92s作为血小板输注的界点值,可有效预防由血小板减低引起的出血。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,预防性血小板输注的阂值确定为APCT≥92s是安全有效的。

Objective To investigate the clinical values of activated plasma clotting time test （ APCT） on prophylactic platelet transfusions. Methods 100 patients with platelet couts 50 × 10 9 / L,29 of 100 patients with bleeding symptoms （ petechiae,epistaxis） and 71 patients without,were involved in the test. Draw their venous blood and collected in sodium citrate,the platelet count and APCT test were performed. Results APCT in bleeding group was obviously prolonged contrast to the non -bleeding group＇ s. There were statistically significant differences between the two groups（ P 0. 05） . The APCT was better than PLT for predicting the bleeding due to thrombocytopenia. Using APCT≥92 s as the cut -off point for prophylactic platelet transfusion would accurately predict major bleeding due to thrombocytopenia. Conclusion APCT reflects the variations of quantity and quality of platelet simultaneously,and can evaluate precisely the efficacy of platelet transfusion. APCT≥92 s as trigger is safety and less cost.