不同治疗量血小板的输注疗效以及影响因素分析

Transfusion efficacy and influencing factors of patients transfused with different therapeutic doses of platelets:a comparative analysis

目的对比分析患者输注不同治疗量血小板的输注疗效,并分析血小板输注无效的危险因素。方法选择2023年5月至2024年5月在本院输注血小板患者5827例作为研究对象。输注1治疗量血小板4780例,输注0.5治疗量血小板1047例,比较2组血小板输注疗效。采用单因素分析的方法,分析患者性别、疾病种类、输注前白细胞计数、发热、血小板输注次数、血小板抗体对血小板输注无效的影响。再进一步使用多因素Logistic回归分析影响患者输注无效的独立危险因素。结果4780例患者输注1治疗量血小板有效3553例(74.3%),无效1227例(25.7%)。1047例患者输注0.5治疗量血小板有效755例(72.1%),无效292例(27.9%)。2组患者输注血小板有效率无明显差异(P>0.05)。单因素分析均发现2组血小板输注疗效与年龄、血小板输注次数、疾病种类、血小板抗体、输注前白细胞计数有关(P<0.05),而性别、发热、血型与血小板输注疗效无关(P>0.05)。多因素分析结果均显示年龄、白细胞计数>50×10^(9)/L、血小板输注次数、疾病种类以及血小板抗体是输注无效的独立危险因素(P<0.05)。结论患者输注0.5治疗量或者1治疗量血小板的输注疗效无明显差异。此外,年龄、白细胞计数>50×10^(9)/L、血小板输注次数、疾病种类以及血小板抗体是2组患者血小板输注无效的影响因素。

Objective To compare and analyze the efficacy of platelet transfusion in patients with different doses,and to analyze the risk factors for platelet transfusion refractoriness.Methods A total of 5827 patients who received platelet transfusion in the PLA General Hospital from May 2023 to May 2024 were selected as the research subjects,among which 4780 patients were transfused with 1 therapeutic dose of platelets,and 1047 patients were transfused with 0.5 therapeutic dose of platelets,and the efficacy of platelet transfusion was compared between the two groups.The effects of gender,dis-ease type,white blood cell count before transfusion,fever,number of platelet transfusions,and platelet antibodies on plate-let transfusion refractoriness were analyzed using univariate analysis,and the independent risk factors affecting platelet transfusion refractoriness were further analyzed by multivariate logistic regression.Results Among 4780 patients,3553(74.3%)were effective and 1227(25.7%)were ineffective.Among 1047 patients,0.5 platelet infusion was effective in 755 cases(72.1%)and ineffective in 292 cases(27.9%).There was no significant difference in the effective rate of platelet transfusion between the two groups(P>0.05).Univariate analysis showed that the therapeutic effect of platelet transfusion was related to age,the number of platelet transfusion,disease type,platelet antibodies and white blood cell count before transfusion(P<0.05),while age,gender,fever and blood type were not related to the therapeutic effect of platelet transfusion(P>0.05).The results of multi-factor analysis showed that age,white blood cell count>50×10^(9)/L,platelet transfusion times,disease type and platelet antibody were independent risk factors for ineffective transfusion(P<0.05).Conclusion There is no significant difference in the efficacy of platelet infusion with 0.5 therapeutic dose or 1 therapeutic dose.In addition,age,white blood cell count>50×10^(9)/L,the number of platelet transfusion,disease type and platelet antibodies were the factors affecting the ineffective platelet transfusion in group 2.