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目的通过检测肿瘤患者血清中的血小板抗体及其血小板配型,对比随机输注组患者和相合输注组患者的血小板治疗效果,进一步评估此方法的临床意义。方法应用固相凝聚法对2011年1月-2015年1月期间在我院住院需要输注血小板的460例肿瘤患者血清标本进行血小板抗体检测,共检出血小板抗体阳性者58例,阳性率为12.6%(58/460)。其中,将58例血小板抗体阳性的肿瘤患者按照血小板输注方式分为两组:实验组采用血小板配型相合后再进行血小板输注共98次,随机输注组直接进行血小板输注共138次,回顾性分析比较两组患者血小板输注前后1h、24h血小板计数增高指数(CCI)、血小板恢复百分率(PPR)以及血小板有效输注之间的差异。结果两组患者在血小板输注前1h,其血小板计数比较无统计学意义(P>0.05)。随机输注组患者与相合输注组患者输注血小板1h、24h后,其CCI和PPR相比较,差异有统计学意义(P<0.01)。结论对肿瘤患者进行血小板抗体检测和配型,进一步了解患者体内血小板抗体产生的情况,有效的改善了肿瘤患者血小板输注无效症状,同时提高了血小板输注的疗效,避免了血小板输注无效而引起患者病情加重恶化和血小板滥用等情况,从而保证了临床治疗效果。
Objective To further evaluate the clinical significance of this method by detecting platelet antibodies and their platelet phenotypes in serum of patients with cancer and comparing the effect of platelet therapy in patients with random infusion group and patients in combination infusion group. Methods Solid-phase agglutination method was used to detect platelet antibodies in 460 cases of patients with transcatheter inpatients admitted to our hospital from January 2011 to January 2015. A total of 58 cases were detected positive for platelet antibodies, the positive rate was 12.6% (58/460). Among them, 58 patients with positive platelet antibody were divided into two groups according to the method of platelet transfusion: In the experimental group, platelet transfusion was performed a total of 98 times after platelet match and random platelet transfusion was performed for 138 times The differences of platelet count index (CCI), platelet recovery percentage (PPR) and effective platelet transfusion between the two groups before and after platelet transfusion were retrospectively analyzed. Results There was no significant difference in platelet count between the two groups 1h before platelet transfusion (P> 0.05). There was significant difference between CCI and PPR in patients of random infusion group and those in matched infusion group (P <0.01). Conclusion Tumor patients with platelet antibody detection and matching, to further understand the patient’s platelet antibody production in vivo, effectively improve the ineffective symptoms of platelet transfusion in patients with cancer, while improving the efficacy of platelet transfusion, to avoid platelet transfusion ineffective Causing the patient to worsen the condition and abuse of platelets and other conditions, thus ensuring the clinical treatment effect.