异基因外周造血干细胞移植患者极期输血影响因素回顾性分析

Factors influencing transfusion in patients with allogeneic peripheral blood stem cells transplantation:a retrospective study

目的回顾性分析异基因外周造血干细胞移植（allo-PBSCT）患者移植极期血液输注情况和影响血液输注量的因素。方法选取2009年1月～2011午12月本院血液科进行的allo-PBSCT患者85例，统计移植极期输注的红细胞和血小板数量及相关影响因素。结果移植极期患者平均红细胞输注量为（8．36±8．24）U，平均血小板输注量为（11．95±8．1）U。40％的患者红细胞输注量不低于8．5U，引起红细胞输注量增多的因素为血小板植入时间、预处理前患者骨髓功能状态（P〈0．01）、供受者HLA配型方式及患者体表面积（P〈0．05）；40％的患者血小板输注量不低于12U，引起血小板输注量增多的因素为血小板植入时间、供受者HLA配型方式（P〈0．01）、供受者ABO血型不合和年龄（P〈0．05）。主要ABO血型不合受者在移植极期的红细胞和血小板的输注量为（11．31±14．16）U和（15．13±10．01）U，明显高于相合受者（P〈0．05）。骨髓功能较重受累患者移植极期红细胞的输注量为（13．22±11．89）U，明显高于基本正常患者（P〈0．05）。结论血小板植入时间和供受者HLA配型明显影响患者移植极期的输血量，供受者ABO血型不合对移植极期的血小板输注会产生影响，预处理前患者骨髓功能状态明显影响移植极期红细胞的输注量。

Objective To explore the influencing factors on transfusion by a retrospective study with patients undergoing allo-PBSCT. Methods 85 patients undergoing allo-PBSCT were enrolled at the Chinese PLA General Hospital between January 2009 and December 2011. Muhivariable logistic regression analysis was used to analyze the influencing factors on transfusion （the amount of red blood cells and platelets infused） in the patients undergoing transplantation. Results The Results showed that the average amount of red blood cell transfused in the patients peri-transplantation was 8. 36 ± 8.24 U, and average amount of platelet transfused was 11.95 ±8. 1 U. Of 85 patients,40% infused red blood cells no less than 8.5 Uo Platelet recovery time after transplantation ,marrow function status before pretreatment （P 〈0. 01 ） ,HLA matching and body surface area （P 〈 0. 05 ） were associated with greater likelihood of more red blood cell infusion. 40% patients infused platelets no less than 12 U,which were affected by platelet recovery time,HLA matching （P 〈0. 01 ） ,donor-recipient ABO incompatibility and age （P 〈 0. 05 ）. The amount of infused RBC and platelet during the peri-transplantation period was respectively 11.31 ± 14. 16 U and 15. 13 ± 10. 01 U in major ABO incompatibility recipients,which was higher than the compatibility recipients （P 〈 0.05 ）. In patients whose marrow function status was poor before pretreatment,the amount of infused RBC was 13.22 ± 11.89 U, much higher than patients with relatively normal marrow function （ P 〈 0.05 ）. Conclusion It is concluded that platelet recovery time and HLA matching can greatly affect the amount of red blood cell and platelet transfused,donor-recipient ABO incompatibility can affect the amount of platelet transfused and marrow function status before pretreatment can affect the amount of RBC transfused in this study.