去白细胞血小板治疗白血病患儿的疗效及影响因素分析

Analysis of curative effect and influencing factors of leukocyte depleted platelets in the treatment of children with leukemia

目的探讨白血病患儿去白细胞血小板治疗的临床疗效及影响因素分析。方法回顾性分析2017年5月至2019年6月承德市妇幼保健院儿科收治的70例需输注血小板治疗的白血病患儿临床资料,分析去白细胞血小板治疗患儿的临床疗效,并采用多因素Logistic回归分析影响疗效的危险因素。结果70例患儿共输注305次,其中输注成功199次,成功率为65.25%;输注后白血病患儿血小板计数明显高于输注前血小板计数,差异具有统计学意义[(65.68±6.87)×10^(9)比(19.14±2.55)×10^(9),t=110.92,P<0.05];单因素分析结果显示,输注有效率与发热、感染、出血、输注频率及脾大有关,差异具有统计学意义(χ^(2)值分别为13.115、8.380、4.194、31.381和7.930,P值均<0.05);多因素Logistic回归分析结果显示,感染、发热是影响输注成功率的独立危险因素。结论去白细胞血小板治疗可显著提高白血病患儿血小板水平,输注前存在感染、发热是影响输注有效率的危险因素。

Objective To investigate the clinical efficacy and influencing factors of leukemic children treated with leukocyte free platelet therapy.Methods The clinical data of 70 children with leukemia who need to be treated by platelet transfusion were analyzed retrospectively from May 2017 to June 2019 in the Department of Pediatrics,Chengde Maternal and Child Health Hospital.The efficacy of leukocyte free platelet therapy in children was analyzed.Multivariate logistic regression analysis was used to analyze the risk factors affecting the efficacy.Results A total of 305 infusions were performed in 70 patients,of which 199 were successful,with a success rate of 65.25%.The platelet count after transfusion was statistically higher than that before transfusion[(65.68±6.87)×10^(9) vs(19.14±2.55)×10^(9),t=110.92,P<0.05].The results of single factor analysis showed that the effective rate of infusion was statistically related to fever,infection,bleeding,frequency of transfusion and spleen size(χ^(2) values were 13.115,8.380,4.194,31.381 and 7.930 respectively,all P values<0.05).The results of multivariate logistic regression analysis showed that infection and fever were independent risk factors affecting the success rate of infusion.Conclusion Leukocyte free platelet therapy can significantly improve the platelet level in children with leukemia.Infection and fever before transfusion are risk factors affecting the efficiency of transfusion.