血液病患者单采血小板输注疗效的影响因素分析

Analysis of the Influencing Factors for the Clinical Efficacy of Platelet Transfusion in the Treatment of Patients with Hemopathy

目的:探讨影响血液病患者血小板输注疗效的因素,为提高血液病患者的临床疗效提供参考依据。方法:选择2013年1月至2015年12月海南省人民医院收治的156例输注单采血小板的血液病患者为研究对象,所有患者单次输入血小板12U(血小板数≥2.5×1011个),观察输注后血小板计数纠正增加指数(CCI),分析病种、脾大、发热、年龄、性别对血小板输注疗效的影响。结果:血小板输注总有效率为71.0%。再生障碍性贫血(AA)者血小板输注有效率为65.9%、特发性血小板减少性紫癜(ITP)为65.7%,急性白血病(AL)为77.7%,骨髓增生异常综合征(MDS)为71.9%,不同病种之间血小板输注有效率比较差异无统计学意义(P>0.05)。发热感染者血小板输注有效率为69.9%,明显低于无发热感染者(77.6%,P<0.05);脾不大者有效率为74.9%,明显高于脾大者(52.86%,P<0.05);男性、女性有效率分别为76.5%、75.8%,<60周岁者与芏60周岁者有效率分别为72.0%、77.3%,差异均无统计学意义(P>0.05)。随着血小板输注次数的升高,血小板输注无效的发生率也显著升高。结论:发热及脾大是影响血液病患者血小板输注疗效的不利因素。

Objective： To investigate the influencing factors for the clinical efficacy of platelet transfusion in the treatment of patients with hemopathy. Methods： 156 cases of patients with hemopathy who were treated by platelet transfusion in our hospital from January 2013 to December 2015 were selected. All the patients were given 12 U platelet（≥2.5×1011）,the corrected count increment（CCI） after transfusion and the effect of disease category,splenomegalia,fever,age,gender with on the clinical efficacy of platelet transfusion were analyzed. Results： The total effective rate of platelet transfusion was 71.0%,which was 65.9%,65.7%,77.7% and71.9% in patients with aplastic anemia（AA）,idiopathic thrombocytopenic purpura（ITP）,acute leukemia（AL）,myelodysplastic syndrome（MDS） respecctively,no significant difference was found between different disease categories（P〈0.05）. The effective rate was 69.9% in febrile patients,which was obviously lower than those non-febrile patients（77.6%,P〉0.05）; the effective rate was 74.9%,which was overtly lower than those with splenomegalia（52.86%,P〈0.05）; no significant difference was found in the effective rate between male and female,〈60 years old and years old（76.5% vs. 75.8%,72.0% vs. 77.3%）（P〉0.05）. With the incease of transfusion times,the incidence of platelet transfusion refractoriness was gradually elevated（P〈0.05）. Conclusions： Splenomegalia and fever were adverse factors for the clinical efficacy of platelet transfusion in the treatment of patients with hemopathy.