目的回顾性分析低剂量单采血小板预防性输注疗效,探索低剂量单采血小板预防性输注的可行性。方法选取2020年11月至2021年9月本院输注血小板的住院患者392名,输注常规剂量(1治疗量)单采血小板为对照组,输注低剂量(0.5治疗量)单采血小板...目的回顾性分析低剂量单采血小板预防性输注疗效,探索低剂量单采血小板预防性输注的可行性。方法选取2020年11月至2021年9月本院输注血小板的住院患者392名,输注常规剂量(1治疗量)单采血小板为对照组,输注低剂量(0.5治疗量)单采血小板为试验组。以输注前后血小板计数、血小板增高值(△PLT)以及24 h血小板计数纠正增加指数(CCI)为观测指标,按病种和性别分析低剂量血小板输注疗效。结果对照组血小板△PLT值和24 h CCI有效输注率均高于试验组(16±16)×10^(9)vs(7±10)×10^(9),71.94%vs 60.46%(P<0.05)。对照组△PLT值约为试验组1.4~3.5倍,有效率约为1~1.4倍。对照组,血小板增高值△PLT为AML(20±14)>AA(14±14)>ALL(13±12)>NHL(9±8)>MDS(7±6);试验组,血小板增高值△PLT(×10^(9))为AA(11±18)>AML(8±8)>ALL(5±7)>NHL(5±7)>MDS(5±16)。24 h CCI,对照组,AML(163/188,86.70%)>AA(23/32,71.88%)>ALL(65/98,66.33%)>MDS(9/17,52.94%)>NHL(12/22,51.55%);试验组,AML(133/188,70.74%)>AA(19/32,59.38%)>NHL(12/22,51.55%)>ALL(47/98,47.96%)>MDS(8/17,47.06%)。AML和ALL 2种疾病的试验组有效输注率分别为70.74%(133/188)、47.96%(47/98),明显低于对照组86.7%(163/188)、66.33%(65/98),差异有统计学意义(P<0.05);其它病种试验组与对照组有效输注率间的差异无统计学意义(P>0.05)。结论低剂量单采血小板预防性输注可缓解供需矛盾,能达到60.46%(237/392)的有效输注率,具有一定的临床应用价值。推荐临床在应用低剂量血小板时,优先选择AML、AA或ALL的患者,尽量避免MDS、NHL患者。展开更多
AIM:To determine the optimal dosage and mechanism of Ginkgolide B(BN52021) on severe acute pancreatitis(SAP) of rats.METHODS:Seventy male Wistar rats were randomly divided into seven groups(10 for each group).Shamoper...AIM:To determine the optimal dosage and mechanism of Ginkgolide B(BN52021) on severe acute pancreatitis(SAP) of rats.METHODS:Seventy male Wistar rats were randomly divided into seven groups(10 for each group).Shamoperation group(SO),SAP model group(SAP),dimethyl sulfoxide(DMSO) contrast group(DMSO),and groups treated with 2.5 mg/kg BN52021(BN1),5 mg/kg BN52021(BN2),10 mg/kg BN52021(BN3),and 20 μg/kg Sandostatin(SS).The SAP model was established in Wistar rats by injecting 5% sodium taurocholate retrogradely into the common bilio-pancreatic duct.The rats of SO,DMSO and BN52021 were injected with 0.9% NaCl,0.5% DMSO and BN52021 through femoral vein 15 min after the operation.The SS group was injected with Sandostatin subcutaneously.All rats were anaesthetized at 6 h after operation,and venous blood was collected to determine the levels of serum amylase and phospholipase A2(PLA2),and pancreas tissue was harvested and stained.RESULTS:There was no significant difference between the SAP and DMSO groups in serum amylase level,PLA2,ascites and pathologic score,but significant difference was found in SAP/DMSO groups compared with those in SO group(P < 0.05) and the levels of serum amylase,PLA2,ascites,and pathologic score were lower in the BN1,BN2,BN3 and SS groups than in the SAP and DMSO groups(P < 0.05).However,among BN1,BN2,BN3 and SS groups,BN2 had the best effect in decreasing the levels of serum amylase and PLA2(P < 0.05).Expression of platelet activating factor(PAF) receptor(PAFR) mRNA and protein showed no significant difference between the SAP and DMSO groups,or among BN1,BN2,BN3 and SS groups,but there was remarkable difference between SAP/DMSO group and SO group(P < 0.05),and expression of PAFR mRNA and protein was higher in the BN1,BN2,BN3 and SS groups than in the SAP and DMSO groups(P < 0.05).PAFR expression was observed in the nucleus and cytoplasm of pancreatic islet cells in Wistar rats by immunohistochemistry.CONCLUSION:By iv injection,5 mg/kg of BN52021 is the optimal dosage for SAP rats.BN52021 may inhibit the interaction/binding of PAF with PAFR.展开更多
文摘目的回顾性分析低剂量单采血小板预防性输注疗效,探索低剂量单采血小板预防性输注的可行性。方法选取2020年11月至2021年9月本院输注血小板的住院患者392名,输注常规剂量(1治疗量)单采血小板为对照组,输注低剂量(0.5治疗量)单采血小板为试验组。以输注前后血小板计数、血小板增高值(△PLT)以及24 h血小板计数纠正增加指数(CCI)为观测指标,按病种和性别分析低剂量血小板输注疗效。结果对照组血小板△PLT值和24 h CCI有效输注率均高于试验组(16±16)×10^(9)vs(7±10)×10^(9),71.94%vs 60.46%(P<0.05)。对照组△PLT值约为试验组1.4~3.5倍,有效率约为1~1.4倍。对照组,血小板增高值△PLT为AML(20±14)>AA(14±14)>ALL(13±12)>NHL(9±8)>MDS(7±6);试验组,血小板增高值△PLT(×10^(9))为AA(11±18)>AML(8±8)>ALL(5±7)>NHL(5±7)>MDS(5±16)。24 h CCI,对照组,AML(163/188,86.70%)>AA(23/32,71.88%)>ALL(65/98,66.33%)>MDS(9/17,52.94%)>NHL(12/22,51.55%);试验组,AML(133/188,70.74%)>AA(19/32,59.38%)>NHL(12/22,51.55%)>ALL(47/98,47.96%)>MDS(8/17,47.06%)。AML和ALL 2种疾病的试验组有效输注率分别为70.74%(133/188)、47.96%(47/98),明显低于对照组86.7%(163/188)、66.33%(65/98),差异有统计学意义(P<0.05);其它病种试验组与对照组有效输注率间的差异无统计学意义(P>0.05)。结论低剂量单采血小板预防性输注可缓解供需矛盾,能达到60.46%(237/392)的有效输注率,具有一定的临床应用价值。推荐临床在应用低剂量血小板时,优先选择AML、AA或ALL的患者,尽量避免MDS、NHL患者。
基金Supported by Two grants from National Natural Science Foundation of China,No. 30300465 and No. 30772883
文摘AIM:To determine the optimal dosage and mechanism of Ginkgolide B(BN52021) on severe acute pancreatitis(SAP) of rats.METHODS:Seventy male Wistar rats were randomly divided into seven groups(10 for each group).Shamoperation group(SO),SAP model group(SAP),dimethyl sulfoxide(DMSO) contrast group(DMSO),and groups treated with 2.5 mg/kg BN52021(BN1),5 mg/kg BN52021(BN2),10 mg/kg BN52021(BN3),and 20 μg/kg Sandostatin(SS).The SAP model was established in Wistar rats by injecting 5% sodium taurocholate retrogradely into the common bilio-pancreatic duct.The rats of SO,DMSO and BN52021 were injected with 0.9% NaCl,0.5% DMSO and BN52021 through femoral vein 15 min after the operation.The SS group was injected with Sandostatin subcutaneously.All rats were anaesthetized at 6 h after operation,and venous blood was collected to determine the levels of serum amylase and phospholipase A2(PLA2),and pancreas tissue was harvested and stained.RESULTS:There was no significant difference between the SAP and DMSO groups in serum amylase level,PLA2,ascites and pathologic score,but significant difference was found in SAP/DMSO groups compared with those in SO group(P < 0.05) and the levels of serum amylase,PLA2,ascites,and pathologic score were lower in the BN1,BN2,BN3 and SS groups than in the SAP and DMSO groups(P < 0.05).However,among BN1,BN2,BN3 and SS groups,BN2 had the best effect in decreasing the levels of serum amylase and PLA2(P < 0.05).Expression of platelet activating factor(PAF) receptor(PAFR) mRNA and protein showed no significant difference between the SAP and DMSO groups,or among BN1,BN2,BN3 and SS groups,but there was remarkable difference between SAP/DMSO group and SO group(P < 0.05),and expression of PAFR mRNA and protein was higher in the BN1,BN2,BN3 and SS groups than in the SAP and DMSO groups(P < 0.05).PAFR expression was observed in the nucleus and cytoplasm of pancreatic islet cells in Wistar rats by immunohistochemistry.CONCLUSION:By iv injection,5 mg/kg of BN52021 is the optimal dosage for SAP rats.BN52021 may inhibit the interaction/binding of PAF with PAFR.
