5508例血小板输注疗效回顾性多因素分析

Retrospective multiple-factor analysis of 5508 cases on the treatment outcomes of platelet transfusion

目的探讨以血小板计数（Plt）为基础的血小板输注疗效评价指标的科学性。方法选取2010年1月—2013年12月在本院各临床科室输注血小板的5 508例病例,按照患者性别、病种、输注血小板的种类、输注量、输血史以及输注血小板后血小板计数复查时间做多因素分组,采用回归分析方法比较各因素与血小板输注前后Plt变化值之间的相关性,采用多因素方差分析方法了解各因素间的交互作用。结果 1）回归分析：与患者输注血小板前后Plt变化值具有相关性的因素包括血小板种类（P〈0.01）、病种（P〈0.05）、输血史（P〈0.01）;2）多因素方差分析：独立因素之间、独立因素与非独立因素之间以及非独立力量因素之间的交互作用没有明显的规律,呈现处错综复杂的关系。结论患者输注血小板前后Plt变化受诸多因素的影响,以Plt为基础的血小板输注疗效评价指标（血小板回收率以及校正血小板增加指数）不能完全客观地反映血小板输注疗效。

Objective To explore the rationality of Plt based evaluation index system for the treatment evaluation of platelet transfusion. Methods 5 508 cases recorded from January 2010 to December 2013 in our hospital were selected and grouped according to multiple factors： gender,diagnosis,type of platelets,transfusion volume,the history of blood transfusion,and detection time after transfusion. A retrospective analysis was performed to compare the correlation between different factors and Plt changes. Results（ 1） Plt changes were independently relevant to the type of platelet transfused（ P〈0. 01）,diagnosis（ P〈0. 05） and the history of blood transfusion（ P〈0. 01）.（ 2） There was no obvious pattern in the interaction between independent factors,independent factors and non-independent factors,and non-independent factors and can only be summarized in case-specific conditions. Conclusion There are many factors affecting Plt changes after transfusion directly or indirectly,so it is very difficult to evaluate the outcome of platelets transfusion by the index which constructed based the Plt index only.