血小板减少性疾病患者2种不同血小板成分输注的临床疗效比较

Clinical significance of different components of platelet transfusion in patients with thrombocytopenic disease

目的:观察临床血小板减少性疾病患者在输注去白细胞单采血小板和单采血小板成分后的临床意义。方法:选取2017-07-2019-02临床各科室需要进行血小板减少性疾病输注血小板治疗的患者163例进行分组研究,统计分析2种血小板成分输注对不同血小板减少性疾病的血小板输注疗效及血小板抗体产生的影响。结果:163例不同疾病组(血液系统非免疫性血小板减少疾病组78例、恶性肿瘤及化疗后血小板减少组23例、外科出血性血小板减少组27例)患者,输注2种类型血小板成分的输注有效率比较,输注去白细胞单采血小板的有效率较输注单采血小板的高,差异有统计学意义(P<0.05);输注去白细胞单采血小板组产生血小板抗体阳性率低于输注单采血小板组,差异有统计学意义(P<0.05);比较输注去白细胞单采血小板组及单采血小板组血小板抗体的分布,结果显示多次输注血小板,单采血小板组较去白细胞单采血小板组更容易产生血小板抗体,差异有统计学意义(P<0.05)。结论:临床血小板减少性疾病需要多次血小板输注治疗时,建议以输注去白细胞单采血小板为主,并监测血小板抗体,有效提高血小板输注有效率,降低血小板抗体产生概率,达到血液资源的安全有效利用。

Objective:To observe the clinical significance of transfusion of different components of platelets in the patients with clinical thrombocytopenic disease.Method:A total of 185 cases requiring platelet transfusion in our clinical departments from July 2017 to February 2019 were selected for group study.The effect of different platelet component transfusions on the efficacy of platelet transfusion and platelet antibody production for different thrombocytopenic diseases was statistically analyzed.Result:Comparison of transfusion efficiencies of different types of platelet components in 163 patients with different disease groups showed that the efficiency of transfusion of white apheresis platelets was higher than that of apheresis platelets transfusion,the difference was statistically significant(P<0.05).The positive rate of platelet antibody in the transfusion of white apheresis platelets group was lower than that in the transfusion of apheresis platelet group,the difference was statistically significant(P<0.05).Comparing the platelet antibody distribution in white cell-derived platelet transfusion group and apheresis platelet transfusion group,the results showed that for multiple platelets transfusion times,platelet antibodies were more likely to be produced in the apheresis platelet transfusion group than the white cell-derived platelet transfusion group.Conclusion:When clinical thrombocytopenic disease requires multiple platelet transfusion therapy,it may be recommended to use transfusion of white apheresis platelets and monitor platelet antibodies,effectively improve platelet transfusion efficiency,reduce platelet antibody production rate,and achieve safe and efficient blood resources use.