儿童造血干细胞移植过程中影响血小板输注效果部分因素探讨

摘要

Objective To observe the influencing factors of platelet transfusion during stem cell transplantation of children. Methods Three hundred and five times of platelet transfusions of patients in blank periods of bone marrow after stem cell transplantation were retrospectively analyzed. The relationship between the incidences of refractoriness of platelet transfusion (RPT) and the genders, platelet inventorial times, original diseases, types of transplantation, the adjusted corrected count increment (aCCI) and were compared respectively. Results Female and auto-HSCT had more effective platelet transfusion,whereas severe aplastic anemia and myelodysplastic syndrome had worse platelet transfusion; no significant meanings were found between the aCCI and the incidence of RPT in platelet inventorial times.Conclusion The genders, original diseases and types of transplantation were important factors in platelet transfusion. The platelet inventorial time had little effect on platelet transfusion.%目的 初步探讨儿童造血干细胞移植过程中影响血小板输注效果的因素.方法 回顾性分析了处于骨髓清空期的造血干细胞移植患儿的305次血小板输注情况,观察患儿性别、所患疾病、移植类型及血小板库存天数与调整后的血小板计数增加值校正指数(aCCI)和血小板无效输注的发生率之间的关系.结果 女性患儿血小板输注效果优于男性(F=2.101,P=0.037),无效输注发生率明显低于男性(χ2=5.968,P=0.015);有效期内的血小板库存天数对aCCI值及无效输注发生率没有显著影响(P=0.346及0.086);急性再生障碍性贫血及骨髓增生异常综合征患儿更易发生无效输注,而自体造血干细胞移植较少发生无效输注.结论 患儿性别、所患疾病及移植类型的不同是影响血小板输注效果的重要原因,而有效期内的库存天数,对血小板的输注效果没有显著影响.