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目的了解并比较机器单采浓缩血小板(简称单采血小板)和手工分离浓缩血小板(简称手工血小板)对免疫性血小板减少症(immune thrombocytopenia,ITP)的治疗效果。方法 2005年1月至2012年12月在四川大学华西第二医院儿科住院符合ITP诊断并输注血小板制品的338例ITP患儿为研究对象。其中输注机器单采血小板患儿251例次为单采制剂组(简称为单采组),输注手工分离血小板制剂患儿87例次为手工制剂组(简称为手采组)。分别在输注后24 h计算血小板计数增加校正指数(CCI)、血小板回升率(PPR)、输注无效率、输注后患儿血小板数值达到≥30×109/L,60×109/L,100×109/L的时间等指标。结果输注24 h后,单采组CCI为23.4,PPR为51%,手采组CCI为24.5,PPR为48.3%,差异无统计学意义。单采组输注无效率为12.7%,明显低于手采组输注无效率22.9%。单采组输注后,患儿血小板数值达到≥30×109/L,60×109/L的中位时间分别为23 h和44.5 h,手采组分别为20 h和48.7 h时,两组差异无统计学意义(P>0.1)。单采组患儿血小板≥100×109/L的中位时间为54 h,手采组为62 h,单采组明显低于手采组(P<0.05)。结论输注单采血小板及手采血小板均能有效提高ITP患儿外周血血小板数值,但输注单采血小板制剂的效果更好。
Objective To understand and compare the therapeutic effects of machine apheresis platelet (LTP) and manual isolation of concentrated thrombocytopenia (platelet) on immune thrombocytopenia (ITP). Methods From January 2005 to December 2012, 338 ITP children with ITP diagnosis and transfusion of platelet products were enrolled in pediatric department of West China Second Hospital, Sichuan University. Among them, 251 cases of children with apheresis machine were single-preparation group (referred to as a-apheresis group), while 87 cases of manual platelet-transfusion group were manual preparation group (referred to as hand-picking group). The corrected index of platelet count (CCI), platelet rise rate (PPR), and ineffectiveness of infusion were calculated 24 h after infusion. The platelet count of infants reached ≥30 × 109 / L, 60 × 109 / L, 100 × 109 / L of time and other indicators. Results After 24 h of infusion, the CCI was 23.4 and the PPR was 51% in the apheresis group. The CCI in the apheresis group was 24.5 and the PPR was 48.3%. The difference was not statistically significant. Aortic transfusion inefficiency was 12.7%, significantly lower than the hand mining group infusion ineffective 22.9%. After transfusion of a single group, the median platelet count of patients reached ≥30 × 109 / L and 60 × 109 / L were 23 h and 44.5 h respectively, while those of the control group were 20 h and 48.7 h respectively The difference was not statistically significant (P> 0.1). The median time of platelet≥100 × 109 / L in the single-episode group was 54 h, while that in the hand-picking group was 62 h, which was significantly lower in the apheresis group than in the sham-tian group (P <0.05). Conclusion Both transfusion of single platelets and platelets can effectively increase the platelet count in peripheral blood of children with ITP, but the effect of single platelet transfusion is better.