急性髓系白血病患者血小板输注疗效的影响因素研究

Study on the Influencing Factors of the Efficacy of Platelet Transfusion in Patients with Acute Myeloid Leukemia

目的探讨急性髓系白血病患者血小板输注疗效不佳的影响因素。方法将2017年6月至2019年6月中国人民解放军北部战区空军医院接受血小板输注治疗的60例急性髓系白血病患者作为研究对象,其中疗效不佳的28例作为疗效不佳组,疗效良好的32例作为疗效良好组。比较两组基线资料,并通过单因素与多因素分析急性髓系白血病患者血小板输注疗效不佳的影响因素。结果两组年龄、性别、抗生素使用、输血史比例对比,差异无统计学意义(P>0.05);疗效不佳组血小板种类(冰冻血小板)、输血次数(≥5次)、脾肿大、出血量(≥400 mL)、感染及白细胞计数异常比例均高于疗效良好组,差异有统计学意义(P<0.05);经多项Logistic回归分析后,建立多元回归模型行多因素分析结果显示,血小板种类(冰冻血小板)、输血次数(≥5次)、脾肿大、出血量(≥400 mL)、感染及白细胞计数异常均是急性髓系白血病患者血小板输注疗效不佳的影响因素(OR>1,P<0.05)。结论血小板种类(冰冻血小板)、输血次数(≥5次)、脾肿大、出血量(≥400 mL)等均会影响急性髓系白血病患者血小板输注疗效,临床应重视有血小板输注疗效不佳风险因素的患者,及早干预治疗,可能对提高患者血小板输注效果有积极意义。

Objective To investigate the influencing factors of poor efficacy of platelet transfusion in patients with acute myeloid leukemia.Methods A total of 60 patients with acute myeloid leukemia who received platelet transfusion in the Air Force Hospital of the Northern Theater of the Chinese People's Liberation Army from June 2017 to June 2019 were included in the study.Twenty-eight patients with poor efficacy were included as the poor efficacy group,and 32 patients with good curative effect were selected as the good efficacy group.The baseline data of the two groups were compared.And the influencing factors of poor efficacy of platelet transfusion in patients with acute myeloid leukemia were analyzed by univariate and multivariate analysis.Results There was no significant difference in age,gender,antibiotic use and blood transfusion history between the two groups(P>0.05).The types of platelets(frozen platelets),times of blood transfusion(≥5 times),splenomegaly,blood loss(≥400 mL),infection and abnormal white blood cell count in the poor efficacy group were all higher than those in the good efficacy group,and the differences were statistically significant(P<0.05).After single logistic regression analysis,multiple regression model was established and multivariate analysis was performed.The results showed that platelet type(frozen platelet),times of blood transfusion(≥5 times),splenomegaly,blood loss(≥400 mL),infection and abnormal white blood cell count were the influencing factors for poor efficacy of platelet transfusion in patients with acute myeloid leukemia(OR>1,P<0.05).Conclusion Type of platelets(frozen platelet),times of blood transfusion(≥5 times),splenomegaly,and blood loss(≥400 mL)affect the efficacy of platelet transfusion in patients with acute myeloid leukemia.Clinical attention should be paid to patients with risk factors for poor efficacy of platelet transfusion.Early intervention and treatment may be of positive significance for improving the effect of platelet transfusion in patients.