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血栓弹力图评估急性白血病患者血小板无效输注出血风险的意义 被引量:2

The clinical significance of thromboelastography in evaluating the bleeding risk in acute leukemia patients with platelet transfusion refractoriness
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摘要 目的探讨血栓弹力图(TEG)对评估急性白血病(AL)患者发生血小板无效输注(PTR)时出血的风险。方法研究成人AL患者PTR组与非PTR组TEG参数的特点,比较PTR组出血组与无出血组的血小板计数(PLT)及TEG参数的差异。结果58例血小板相关抗体阳性AL患者发生PTR的比例为48.28%。PTR患者采用输注大剂量丙球共20例,输注有效率为40%,PTR患者采用输注配型血小板共26例,输注有效率为42.62%。分析41例PTR组与59例非PTR组的TEG参数,PTR组血小板输注前与输注后PLT值、R值、K值、α角、MA值差异均无统计学意义;非PTR组血小板输注后PLT值、MA值显著高于输注前(P<0.05),其余参数差异均无统计学意义(P>0.05)。非PTR组与PTR组比较,输注后PLT值、MA值均明显高于PTR组(P<0.05)。PTR组患者出血组与无出血组的PLT值及TEG相关参数比较,PLT值、TEG的R值、K值、α角差异无统计学意义(P>0.05),而无出血组的MA值明显高于出血组(P<0.05)。结论发生PTR的AL患者单纯血小板计数不能准确反映患者发生出血风险,TEG MA值可以有助于评估AL患者的出血风险。 Objective Exploring the use of thromboelastography(TEG)to assess the risk of bleeding in patients with acute leukemia(AL)undergoing platelet transfusion refractoriness(PTR).Methods To investigate the differences in TEG parameters between the PTR group and the non⁃PTR group in adult AL patients,and compare the differences in PLT and TEG parameters between the bleeding group and the non⁃bleeding group in the PTR group.Results A total of 58 AL patients were positive for platelet⁃related antibodies,and the proportion of PTR was 48.28%.A total of 20 patients with PTR were transfused with large⁃dose immunoglobulin,the effective rate was 40%,and 26 patients with PTR were transfused with matching platelets,the effective rate was 42.62%。This study observed the difference of TEG parameters between the PTR group and the non⁃PTR group,and the results showed that there were no significant differences in PLT,R value,K value,αAngle and MA value before and after platelet transfusion in the PTR group.The PLT and MA values of the non⁃PTR group were significantly different before and after transfusion(P<0.05),while the R value,K value andαAngle were not significantly different.The PLT and MA values of the non⁃PTR group were significantly higher than those in PTR group after transfusion(P<0.05).Analysis and comparison of PLT and TEG parameters between the bleeding group and the non⁃bleeding group in patients with PTR showed that there was no significant difference in PLT value,R value,K value andαAngle of TEG,while MA value in the non⁃bleeding group was higher than that in the bleeding group,with significant difference(P<0.05).Conclusions Platelet count alone cannot accurately reflect the risk of bleeding in AL patients with PTR.TEG can effectively predict and evaluate the bleeding risk in AL patients,among which the maximum amplitude index has the most significant clinical significance,which is of great significance for disease evaluation and treatment guidance.
作者 任俊 林婉颐 周振海 REN Jun;LIN Wanyi;ZHOU Zhenhai(Department of Blood Transfu-sion,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;不详)
出处 《实用医学杂志》 CAS 北大核心 2024年第9期1225-1229,1237,共6页 The Journal of Practical Medicine
基金 广东省基础与应用基础研究基金委员会自然科学基金面上项目(编号:2022A1515011092) 广东省基础与应用基础研究基金委员会企业联合基金-面上项目(编号:2021A1515220079)。
关键词 血小板输注无效 血栓弹力图 血小板计数 platelet transfusion refractoriness thrombelastography platelet count
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