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目的探讨影响急性白血病(AL)患者血小板无效输注(PTR)的相关非免疫因素。方法回顾性分析81名AL患者输注机采血小板184次的临床资料,据血小板纠正增加指数(CCI)分析PTR率及其非免疫相关因素。结果本组AL患者的PTR率为33.70%(62/81);按年龄分组,成年与儿童患者的PTR率分别为39.20%(49/125)与17.39%(4/23)(P<0.05);按ABO血型分组,A与O型血患者的PTR率分别为40.51%(32/79)与22.39%(15/67)(P<0.05);按有无脾大分组,脾肿大与无脾肿大患者的PTR率分别为43.75%(28/64)与28.33%(34/120)(P<0.05);按有无发热分组,发热与无发热患者的PTR率分别为41.77%(33/105)与27.62%(29/79)(P<0.05);按有无感染分组,感染与无感染患者的PTR率分别为43.75%(42/96)与22.73%(20/88)(P<0.05);按有无败血症分组,有败血症与无败血症患者的PTR率分别为60.00%(9/15)与40.74%(33/81)(P>0.05);按输注血小板前使用激素与否分组,使用与未用激素患者的PTR率分别为27.78%(30/108)与42.10%(32/76)(P<0.05)。按性别、是否妊娠、AL类型、药物影响(化疗药物、抗生素)分组比较,PTR率无统计学意义(P>0.05)。结论发热、感染、脾脏肿大、年龄、ABO血型可能为导致AL患者PTR的相关非免疫因素。输注血小板前使用激素可能会减少AL患者PTR的发生。性别、妊娠、AL类型、某些药物(化疗药物、抗生素)与PTR可能无关。
Objective To investigate the related non-immune factors that affect platelet transfusion ineffective (PTR) in patients with acute leukemia (AL). Methods A retrospective analysis of clinical data of 81 AL patients with 184 platelet transfusions was performed. The rate of PTR and its non-immune related factors were analyzed according to the Platelet Correction Augmentation Index (CCI). Results The PTR rate in patients with AL was 33.70% (62/81). The PTR rates of adults and children were 39.20% (49/125) and 17.39% (4/23) respectively by age group (P <0.05) ; According to the ABO blood grouping, the PTR rates of patients with type A and type O blood were 40.51% (32/79) and 22.39% (15/67) respectively (P <0.05); The patients with splenomegaly and splenomegaly The PTR rates of patients with splenomegaly were 43.75% (28/64) and 28.33% (34/120) respectively (P <0.05). The PTR rates of patients with or without fever were 41.77% (33 / P <0.05). The PTR rates of infected and noninfected patients were 43.75% (42/96) and 22.73% (20/88), respectively <0.05). The PTR rates of patients with and without sepsis were 60.00% (9/15) and 40.74% (33/81) respectively (P> 0.05) No PTR rates were 27.78% (30/108) and 42.10% (32/76) in patients with and without hormone therapy (P <0.05). There was no significant difference in PTR rates between groups by sex, pregnancy, AL type and drug effect (chemotherapeutic drugs and antibiotics) (P> 0.05). Conclusion Fever, infection, enlargement of spleen, age, ABO blood group may be the related non-immune factors leading to PTR in AL patients. The use of hormones before platelet transfusion may reduce PTR in AL patients. Sex, pregnancy, AL type, some drugs (chemotherapy drugs, antibiotics) may have nothing to do with the PTR.