中国医学科学院学报2011，Vol.33Issue(4)：412-420,9.DOI:10.3881/j.issn.1000-503X.2011.04.013
白细胞滤过的血小板预防血小板输注无效和人类白细胞抗原同种免疫反应的Meta分析
Prevention of Platelet Transfusion Refractoriness and HLA-alloimmunization by Leukocyte-filtered Platelet Transfusion: A Meta-analysis
摘要
Abstract
Objective To compare and assess the effectiveness of leukocyte-filtered platelet and standard platelet concentrates transfusion in preventing platelet transfusion refractoriness ( PTR) and human leukocyte antigen (HLA) -alloimmunization. Methods Randomized controlled trials (RCTs) or quasi-RCTs comparing leukocyte-filtered platelet with standard platelet concentrates transfusion ( up to December 31,2009) were searched and identified from Medline, EMBASE, The Cochrane Library, and CBM. A meta-analy-sis was conducted with Cochrane Collaboration's RevMan 5. 0. Results The search identified 558 citations in total, in which 7 articles in English were finally included in the meta-analysis. The analysis showed that compared with standard platelet concentrates transfusion, leukocyte-filtered platelet transfusion significantly decreased PTR [ RR = 0. 59, 95% CI (0.42, 0. 82), P = 0. 002 ] and HLA-alloimmunization [ RR = 0. 49, 95% CI (0. 33 , 0. 74) , P = 0. 0006 ]. Subgroup analysis showed that HLA-alloimmunization was significantly reduced by leukocyte-filtered platelet transfusion among the patients with acute myelocytic leukemia [ RR = 0. 42, 95% CI (0. 32, 0. 56 ) , P < 0. 00001 ], while no significant difference was detected in patients with acute lymphoblastic leukemia because of the limited sample size [ RR = 0. 50, 95% CI (0. 10, 2. 41) , P = 0. 39 ]. Conclusions The current evidence shows that leukocyte-filtered platelet transfusion can prevent PTR and HLA-alloimmunization more effectively than standard platelet transfusion. Well-designed large-scale RCTs are still needed to further confirm this finding.关键词
白细胞滤过/血小板输注无效/人类白细胞抗原同种免疫反应/Meta分析Key words
leukocyte-filtered/ platelet transfusion refractoriness/ human leukocyte antigen alloimmunization/ Meta-analysis分类
医药卫生引用本文复制引用
袁强,陈雪,成岚,周昌华,傅雪梅,李幼平,王乃红,王莉..白细胞滤过的血小板预防血小板输注无效和人类白细胞抗原同种免疫反应的Meta分析[J].中国医学科学院学报,2011,33(4):412-420,9.基金项目
成都市卫生局2009年青年基金科研课题(0916、 0917) Supported by 2009 research fund for young scholars by Chengdu Health Bureau (0916,0917) （0916、 0917）
第一、二位作者对本文贡献一致The first two authors contributed equally to this article （）
