血小板参数在血小板输注疗效及患者预后评估中的价值

The value of platelet parameters in the efficacy of platelet transfusion and patient prognosis

目的探讨血小板参数与血小板输注疗效及患者预后判断的相关性,为临床治疗提供指导依据。方法以2016年1月-2018年11月在本院输注机采血小板的患者91例为研究对象,根据24 h血小板纠正指数(CCI)分为有效组(62例)和无效组(29例),分别收集2组患者输注前和输注后24 h的各项血小板参数,以及输注后5 d的血小板计数,对血小板参数与输注疗效和患者预后的相关性进行回顾性分析。结果血小板输注前2组患者的血小板计数(PLT)、血小板比积(PCT)、血小板分布宽度(PDW)、平均血小板体积(MPV)比较,差异均无统计学意义(P>0.05);输注后24 h,有效组患者各项血小板参数(PLT、PCT、MPV、PDW)均明显高于无效组(P<0.05);有效组患者输注后5 d血小板计数升高到正常范围的比例高于无效组,且血小板升高的患者输注后24 h的MPV、PDW高于输注前。结论血小板参数尤其是MPV和PDW的变化情况与血小板输注的疗效和预后判断有显著相关性,血小板参数可为临床制定血小板输注治疗方案提供指导依据。

Objective To explore the correlation between platelet parameters and the efficacy and prognosis of platelet transfusion,so as to provide basis for clinical treatment.Methods A total of 91 patients who underwent platelet transfusion in our hospital from January 2016 to November 2018 were enrolled.Patients were divided into effective group(n=62)and invalid group(n=29)according to the twenty-four hours platelet correction index(CCI).The platelet parameters of the two groups before and after the platelet transfusion,the platelet count of five days after the transfusion were collected,and the correlation between platelet parameters and transfusion efficacy and prognosis was retrospectively analyzed.Results Before platelet transfusion,there was no statistical significance on the differences in platelet count(PLT),platelet specific volume(PCT),platelet distribution width(PDW),and mean platelet volume(MPV)between the two groups(P>0.05).After transfusion,platelet parameters(PLT,PCT,PDW,MPV)of the patients in the effective group were significantly higher than those in the invalid group(P<0.05).In the effective group,the percentage of platelet counts rising to the normal range after 5 days of transfusion was higher than another group.Patients with elevated platelets had higher MPV and PDW at 24 hours after transfusion than before transfusion.Conclusion The changes of platelet parameters,especially MPV and PDW,are significantly correlated with the efficacy and prognosis of platelet infusion.Platelet parameters can provide guidance for the clinical development of platelet transfusion therapy.