未成熟血小板分数对化疗患者输注血小板的预测作用

The role of immature platelet fraction in the prediction of platelet transfusion in cancer patients after chemotherapy

目的:通过检测外周血的未成熟血小板分数(IPF%)了解骨髓生成释放血小板(PLT)的能力,以期预测化疗患者是否需要输注PLT,避免不必要的PLT输注。方法:收集温州医科大学附属第二医院化疗住院患者186例,其中输血组74例、未输血组112例,利用SYSMEX XE-5000全自动血液分析仪的网织红细胞通道检测患者血常规标本的IPF%、IPF及PLT等指标,比较输血组和未输血组各检测指标的差异。接着对输血组患者的血小板和IPF%进行动态观察,并利用ROC曲线评价各项指标预测是否需输注PLT的效果。结果:输血组的,10.68%)]高于未输血组的,3.50%)],差异有统计学意义(P<0.05)。而输血组的,123.75×109/L)]低于未输血组[150.50×109/L(94.75×109/L,209.00×109/L)],差异有统计学意义(P<0.05)。动态结果分析发现IPF%随着PLT的下降而升高。通过ROC曲线分析发现IPF%的AUC和PLT的AUC没有差异。结论:IPF%升高提示外周血中PLT破坏增加,但尚无法作为化疗患者是否需输注PLT的预测指标。

Objective:To investigate whether immature platelet fraction(IPF%)predicate imminent platelet recovery after chemotherapy for the cancer patients,so that unnecessary platelet transfusion can be avoided.Methods:A total of 186 patients were enrolled and divided into blood transfusion group and non-transfusion group.IPF%of anticoagulated blood with EDTA-K2 was evaluated by means of the IPF master program equipped with SYSMEX XE-5000.The differences between IPF%and PLT of blood transfusion group were analyzed dynamically.The ROC curve was performed to evaluate the effect of those indictors in predicting whether PLT transfusion was needed.Results:The IPF%in the blood transfusion group[5.10%(2.48%,10.68%)]was higher than that in the non-transfusion group[1.85%(1.20%,3.50%)],and the blood platelet count in the blood transfusion group[35.00×109/L(12.75×109/L,123.75×109/L)]was lower than in the non-transfusion group[150.50×109/L(94.75×109/L,209.00×109/L)](P<0.05).There was an increase of IPF%during PLT nadir.The results of ROC analysis demonstrated that there was no statistical difference between the AUC of PLT and IPF%.Conclusion:Increased IPF%indicates PLT destruction in peripheral blood,but IPF%measurement lacks the predictive power regarding imminent PLT recovery in cancer patients.Therefore decisions regarding prophylactic PC transfusions should not be based on this parameter.