血液病患者血小板输注效果评价及其影响因素探讨.pdfVIP

齐齐哈尔医学院学报2007年第28卷第2O期 · 2439 · 血液病患者血小板输注效果评价及其影响因素探讨 蒋俊煌 严 俊 刘永武 林素霞 【摘要】 目的 探讨血液病患者血小板输注的有效率及其影响因素。方法 对79例血液病患者 给予输注机采血小板共 322例次，输注后 18～24小时进行外周血血小板计数，根据血小板回收率 (PPR)和血小板计数增高指数(CCI)评价血小板输注效果，并探讨其影响因素。结果 急性白血病 (AL)、再生障碍性贫血(AA)、特发性血小板减少性紫癜(ITP)和骨髓增生异常综合征(MDS)患者血小 板输注有效率分别为74．39 、71．86 、50．54 和63．64 (P0．01)。AI MDs组中发热患者血小 板输注有效率低于未发热患者(分别为P0．01和P0．05)。AL、MDS组中脾脏肿大患者血小板输 注有效率低于脾脏不肿大患者(P0．01)。AL患者是否发生弥漫性血管内凝血(DIC)血小板输注有 效率有显著差别(P 0，05)。无并发症组患者血小板输注有效率随输注次数的增加而下降 (P 0．01)，而有并发症组患者血小板输注有效率与输注次数关系不大(P0．05)。结论 输注血小板是预 防和治疗因血小板减少或血小板功能障碍而引起的出血的最有效的措施。引起血小板输注无效的病因 复杂，发热、脾肿大、DIc、输注次数等是影响血小板输注效果的重要因素。 【关键词】 血液病 血小板输注 血小板回收率 血小板计数增高指数 疗效 Curative effects of platelet transfusion and its influence factors in patients with hematologic diseases Jiang Junhuang，et a1． (The Affiliated Hospital of Putian College，Putian，Fujian 351100 China) [Abstract】 0bjective To explore the efficacy and influence factors of patelet transfusion in pa— tients with hematologic diseases、Methods The engine picked platelet were transfused 322 times to 79 patients．Peripheral blood platelet count was made at 18 to 24 hours after platelet transfusion．The effec— tiveness was assayed by percentage platelet recovery(PPR)and corrected count increment(CCI)．And then the influence factors were analyzed．Results The effective rate of acuteleukemia(AI )，aplastic ane— mia(AA)，idiopathic throbocytopenic purpura(ITP)and myelodysplastic syndrome(MDS)were 74．39 ％，71．86％，50．54％ and 63．64％ respectively(P 0．01)．For patients with AL or MDS，the effec— tive rate of fever group was lower than non—fever group(P 0．01 and P 0．05 respectively)．The same was to the splenomegaly group and non— splenomegaly group(P 0．01)．In AI patients，there was a significant difference in the disseminated intravascular coagulation(DIC)group and the group with— out DIC(P 0．05)．In non—complication group，the effective rate decreased with the frequen