摘要
目的探讨降低预防性血小板输注剂量对慢性血小板减少症（chronic thrombocytopenia）患者出血的影响。方法选择2008年10月至2010年12月在本院住院的80例因造血干细胞移植（hematopoietic stem cell transplantation，HSCT）、血液系统肿瘤和实体瘤化疗引起的慢性血小板减少症患者（血小板计数〈10×10^9／L）为研究对象。其中位年龄为45岁[（32～68）岁]。将其按照预防性血小板输注接受剂量不同，分为低剂量组[1．1×10^11／m^2（体表面积）]（n=40）和标准剂量组[2．2×10^11／m^2（体表面积）]（n=40），每天检测记录疗效。根据wH0关于出血的四级分级标准，记录并分析超过二级的出血情况（本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书）。两组患者年龄、性别和其他内科疾病史等比较，差异无显著意义（P〉0．05）。结果在80例接受至少1次预防性血小板输注的血小板减少症住院患者中，WHO关于出血分级超过二级别的出血人数在低剂量组和标准剂量组分别为60．0％和62．5％，两组比较，差异无显著意义（P〉0．05）；WHO关于出血分级为三、四级的输注不良反应率在低剂量组和标准剂量组间比较，差异无显著意义（P〉0．05）。低剂量组患者与标准剂量组比较，在整个病期内所输注血小板总量显著降低[（7．92±1．49）×10^11／m^2（体表面积）VS．（12．06±1．79）×10^11／m^2（体表面积）]，差异有显著意义（P〈0．05）；平均血小板输注次数降低[（5．8土1．2）次VS．（4．3±1．0）次]，差异有显著意义（P〈0．05）。结论降低预防性血小板输注剂量，对慢性血小板减少症患者的输血后出血风险无显著影响，并可使血小板输注总量显著降低。
Objective To investigate the effect of reducing prophylactic platelet transfusion dose on bleeding in patients with hypoproliferative thrombocytopenia. Methods From October 2008 to December 2010, we randomly assigned 80 cases hospitalized patients undergoing hematopoietic stem-cell transplantation（HSCT） or chemotherapy for hematologic cancers or solid tumors to receive prophylactic ptatelet transfusions. According to dosage of platelet transfusion divided them into low dose group[at a low dose of 1.1×10^11/m^2 （body-surface area） , n=40] and standard dose group[at a standard dose of 2.2×10^11/m^2 （body-surface area）, n=40]. Clinical signs of bleeding were assessed daily. The primary end point was bleeding of grade 2 or higher （as defined on the basis of World Health Organization criteria）. There was no significance of age, sexuality and others diseases between two groups. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Affiliated Zhongshan Hospital of Dalian University. Informed consent was obtained from all participants. Results In the 80 patients who received at least one platelet transfusion, the primary end points were observed in 60.0% and 62.5% of the patients in the low-dose group and the standard-dose group. There was no significance（P〉0.05）, respectively. The incidences of higher grades of bleeding, and other adverse events were similar between two groups. The median number of platelets transfused was significantly lower in the low-dose group than in the standard-dose group[（7.924±1.49）×10^11/m^2（body surface area） vs. （12. 06±1. 79）×10^11/m^2（body-surfacearea） P〈0.05]. The median number of platelet transfusions given was significantly lower in the low dose group than in the standard-dose groupE（5.8±1.2） vs. （4.3±1.0） ; P〈0.05]. Conclusion Low dose of platelet administered as a prophylactic transfusion had no effect on the incidence of bleeding in stable thrombocytopenia patients, and led to a decreased number of platelet transfused per patient.
出处
《国际输血及血液学杂志》
CAS
2011年第4期295-298,共4页
International Journal of Blood Transfusion and Hematology
关键词
血小板
剂量
预防性输注
出血
platelet
dose
prophylactic transfusion
bleeding
