血小板储存时间与重症病患临床疗效及预后的相关性

Correlation analysis of storage time of platelet products with infusion efficacy and prognosis

目的探讨血小板(PLT)储存时间与重症病患临床疗效及预后之间的相关性。方法收集2016年1月至2019年12月广州多家医院ICU室收治的单采血小板输注治疗的患者资料,共1350例,根据输注效果分为PLT输注有效组(n=858)和PLT输注无效组(492),再根据PLT储存时间将PLT输注有效患者分为≤3 d(n=260)、4 d(n=233)、5 d(n=365)组,分析不同储存时间与患者疗效及预后的关系。结果不同PLTs储存时间患者输注无效率比较差异无统计学意义(P>0.05)。858例PLT输血有效患者中,不同PLTs储存时间患者基本资料、ICU入院诊断、合并症以及ICU治疗变量(呼吸机、肾移植需求)比较差异均无统计学意义(P>0.05)。不同PLT储存时间患者死亡率、血培养阳性率、尿培养阳性率比较,差异无统计学意义(P>0.05)。Kaplan-Meier生存分析显示,显示调整混杂因素后,输注血小板的储存时间与死亡率无关(4 d vs.≤3 d,HR=0.86,95%CI:0.47~1.35;5 d vs.≤3 d,HR=1.06,95%CI:0.69~1.45;P>0.05)。结论PLT储存时间与重症患者或血液病患者的临床疗效及预后无关。

Objective To investigate the correlation of platelet(PLT)storage time with clinical efficacy and prognosis of patients.Methods The data of 1350 patients treated with platelet transfusion in the ICU rooms of multiple hospitals in Guangzhou from January 2016 to December 2019 were collected.According to the effect of transfusion,they were dividedinto PLT blood transfusion effective group(n=858)and PLT blood transfusion ineffective group(492).According to the PLTstorage time,patients with effective PLT blood transfusion were divided into groups≤3 d(n=260),4 d(n=233),and 5 d(n=365).The relationship between different storage time and patient efficacy and prognosis was analyzed.Results Different PLTs storage time did not affect the platelet transfusion efficiency(P>0.05).There was no significant differences inthe basic data,ICU admission diagnosis,comorbidities,and ICU treatment variables(ventilators,kidney transplantrequirements)between the PLT blood transfusion effective group and PLT blood transfusion ineffective group(P>0.05).There was no significant differences in the patient mortality,blood culture positive rate,and urine culture positive rateamong different PLTs storage time(P>0.05).Kaplan-Meier survival analysis showed that after adjusting for confoundingfactors,the storage time of platelet transfusion was not related to mortality(4 d vs.≤3 d,HR=0.86,95%CI:0.47~1.35;5 dvs.≤3 d,HR=1.06,95%CI:0.69~1.45;P>0.05).Conclusion PLT storage time would not affect the clinical efficacy ofplatelet transfusion and prognosis of critically ill patients or hematological patients.