0.5治疗量单采血小板在儿科患者中的输注效果分析

Transfusion effect of 0.5-dose of apheresis platelet in pediatric patients

目的探讨0.5治疗量单采血小板在儿科患者中的输注效果。方法选取本院2021年8月—2022年6月输注0.5治疗量血小板患儿共195例,收集患儿输注血小板前后24 h内血小板计数值(Plt)并按性别、疾病类型、血制品输注史、血小板抗体筛查结果、血小板储存时间、体重进行分组,对血小板输注效果进行分析。结果195例患儿中输注0.5治疗量单采血小板有效率为77.4%(151/195),无效率为22.6%(44/195)。血小板输注次数>3次对血小板输注效果有显著影响,血小板输注有效率由80.8%下降到65.9%(P<0.05),CCI由11.56±8.94下降到8.52±8.42(P<0.05)。血小板抗体结果阳性组较阴性组输注效果显著下降,CCI由11.39±8.87下降到7.82±8.59(P=0.05)。直线回归分析显示,血小板输注效果随着血小板储存时间增加而下降(P<0.05),且患儿体重20 kg以上与20 kg以下相比血小板输注效果下降,血小板输注有效率由84.1%下降到63.5%(P<0.05)。不同性别、疾病、红细胞输注次数对输注效果无显著影响。结论在20 kg以下的患儿中,0.5治疗量的血小板有较好的治疗效果。血小板抗体筛查结果和血小板输注次数对患儿血小板输注效果影响较大,且输注效果随血小板储存时间增加而下降。

Objective To investigate the transfusion effect of 0.5-dose of apheresis platelet in pediatric patients.Methods A total of 195 children who underwent 0.5-dose platelet transfusion from August 2021 to June 2022 were enrolled,and the platelet count within 24 hours before and after platelet transfusion were recorded.They were grouped by gender,disease type,blood product transfusion history,platelet antibody results,platelet storage time and weight to analyze the effect of platelet transfusion.Results Among 195 cases,77.4%(151/195)were effective and 22.6%(44/195)were ineffective after 0.5-dose of platelet transfusion.Platelet transfusion more than three times has significant impact on the effectiveness of platelet transfusion,with platelet transfusion efficiency decreased from 80.8%to 65.9%(P<0.05),and CCI decreased from 11.56±8.94 to 8.52±8.42(P<0.05).The transfusion effect of the HLA and HPA antibodies positive group was significantly lower than the negative group,with CCI decreased from 11.39±8.87 to 7.82±8.59(P=0.05).Linear regression analysis showed that the effect of platelet transfusion decreased with the increasing of platelet storage time(P<0.05),and the effect of platelet transfusion decreased in children weighing less than 20 kg compared with those weighing more than 20 kg,with the effective rate decreased from 84.1%to 63.5%(P<0.05).Different gender,disease type and the number of red blood cell transfusions had no significant effect on platelet transfusion.Conclusion The 0.5-dose platelet transfusion has good therapeutic effect in children below 20 kg.The results of HLA and HPA antibodies and the number of platelet transfusions greatly influence the effect of platelet transfusion in children,and the transfusion effect decreases with the increase of platelet storage time.