血小板配合性输注对白血病患者血小板抗体的影响分析

Analysis of effect of cross-match platelet transfusion on platelet antibody in patients with leukemia

目的 探讨血小板配合性输注对白血病患者血小板抗体的影响分析。方法 选择2019年8月—2021年3月在河南省人民医院血液科入住的108例白血病患者,且在首次输注血小板前,血小板抗体检测为阳性者,通过是否进行血小板配合性输注,将研究对象分为血小板配合性输注组和随机输注组。分别在首次血小板抗体检测后2周、4周、8周和12周进行了血小板抗体检测,并进行结果判读与记录。血小板抗体阳性强度减弱>1+或转阴,记录为有意义的变化。比较两组血小板抗体阳性强度的减弱或转阴率,比较两组不良反应发生率和血小板输注无效率,并分析血小板输注次数对血小板抗体转阴的影响。结果 配合性输注组血小板抗体阳性强度减弱或转阴率高于随机输注组(P<0.05)。配合性输注组不良反应发生率和血小板输注无效率均低于随机输注组(P<0.05)。血小板输注次数越高,血小板抗体转阴率越低,但配合性输注组的转阴率要高于随机输注组(P<0.05)。结论 在血小板输注前,进行血小板抗体检测和血小板配合性输注,有利于血小板抗体的消失和减弱,对血小板输注无效的白血病患者有重要的临床意义。

Objective To investigate the effect of cross-match platelet transfusion on platelet antibody in patients with leukemia. Methods From August 2019 to March 2021,108 hospitalized leukemia patients admitted to the Department of Hematology of Heman provincial People’s Hospital were slected and detected in platelet antibodies before the first platelet transfusion and the platelet antibody were positive. Based on different ways of platelet transfusion, the cases of leukemia patients were divided into two groups: cross-match transfusion group and random transfusion group. The detection of platelet antibody were performed at 2,4,8 and 12 weeks after the initial platelet antibody test, and the results were interpreted and recorded. The positive intensity of platelet antibody decreased >1+ or turned negative, which was recorded as a meaningful change. The decrease or negative rate of antibody, the rate of transfusion adverse reaction and platelet transfusion refractory were compared between the two groups, and the influence of platelet transfusion frequency on antibody negative was analyzed. Results The decrease or negative rate of antibody was higher in cross-match transfusion group than that of random transfusion group(P<0.05),the rate of transfusion adverse reaction and platelet transfusion refractory in cross-match transfusion group were lower than those of random transfusion group(P<0.05).The higher platelet transfusion frequency, the lower platelet antibody negative, but the negative rate of cross-match transfusion group was higher than that of random transfusion group(P<0.05). Conclusion Before the first platelet transfusion, platelet antibody detection and cross-match transfusion are beneficial to the disappearance and weakening of platelet antibody, which has important clinical significance for leukemia patients with platelet transfusion refractory.