高萌 1傅云峰 1赵国胜 1马金旗 1刘凤霞 1黄蓉 1桂嵘1
作者信息
- 1. 中南大学湘雅三医院输血科 长沙,410013
- 折叠
摘要
Abstract
Objective To analyze the clinical efficacy and influencing factors of platelet transfusion in children with acute lymphoblastic leukemia(ALL).Methods From January 1st,2013 to June 30th,2016,ALL patients younger than 14 years old with initial diagnosis and treatment in hematology department or pediatrics department of the Third Xiangya Hospital of Central South University were recruited in this study,and they had at least once apheresis platelets (APs) transfusion.They all infused APs that had same group of ABO and Rh with themselves.The clinical efficacy was evaluated by 24 h corrected count increment (CCI),percentage plate recovery (PPR) and clinical symptoms.The patients with CCI ＞ 4.5,PPR ＞ 20％ and the hemorrhage symptom controlled were defined as effective,if not,they were defined as noneffective.The factors that may influence efficacy (including age,gender,fever,hemorrhage,splenomegaly,infection,using cephalosporins and times of platelet transfusion) were analyzed.Results Total 302 times of platelet transfusion were performed in 44 patients,the average time of each patients was (6.1±5.6).197 times of transfusion were effective (65.2％),the other 105 times were noneffective.The platelet counts before and after platelet transfusion were (19.2±9.4) × 109 · L-1 and (66.1 ± 36.2) × 109 · L-1,it was significant increased (t =11.19,P＜ 0.01).The effective rates of once (n =44),2-5 times (n =93),6-10 times (n =67) and more than 10 times (n =98) were 84.1％,76.3％,56.7％ and 52.0％,respectively.Patients with fever,hemorrhage,splenomegaly,infection and transfusion repeatedly had a poor efficacy than the patients without these factors (P＜ 0.05).The above factors were analyzed by multivariate logistic regression,it showed that fever (OR =3.737,95％CI:1.213 to 11.513) and infusion (OR =3.258,95％CI:1.019 to 10.419) were independent risk factors.Conclusion The platelet count and clinical symptoms were significantly improved after platelet transfusion.Fever and infection were the main risk factors of clinical efficacy of platelet transfusion in children with ALL.关键词
急性淋巴细胞白血病/血小板输注/疗效Key words
Acute lymphoblastic leukemia/Platelet transfusion/Clinical efficacy
