冰冻血小板的临床疗效及其保存液二甲亚砜对人体的影响研究
|
摘要
目的评价冰冻血小板临床输注的有效性,以及冰冻血小板的保存液二甲亚砜(DMSO)对人体的影响。方法选择2016年1月1日至2017年6月30日在西南医科大学附属医院输注过血小板并符合纳入标准的319例患者,按输注血小板制品的不同分为3组,单采组(新鲜单采血小板)105例;浓缩组(手工浓缩血小板)102例;冰冻组(冰冻血小板)112例。检测3组患者的24h血小板纠正指数(CCI),输注血小板的有效率,输血不良反应率,比较3组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总清蛋白(TP)、碱性磷酸酶(ALP)。结果 3组间的24hCCI比较差异有统计学意义(Z=15.288,P<0.01)。3组间的输血不良反应率比较差异有统计学意义(χ~2=6.054,P=0.048)。患者输注冰冻血小板和新鲜单采血小板前后的生化指标(ALT,AST,TP,ALP)比较差异无统计学意义(P>0.05);同病种的患者输注不同剂量的冰冻血小板后的生化指标,以及输注相同剂量的冰冻血小板后不同时间段生化指标的变化值比较,差异均无统计学意义(P>0.05)。结论冰冻血小板输注疗效好,其保存液DMSO对人体无明显的毒副作用,值得推广。
Objective To evaluate the effectiveness of frozen platelet clinical transfusion and the effect of its preserving solution dimethyl sulfoxide(DMSO)on human body.Methods A total of 319 patients who had received platelet infusion in the Affiliated Hospital of Southwest Medical University from January 1,2016 to June 30,2017 and met the inclusion criteria were selected and divided into 3 groups according to different platelet infusion products:105 cases in the apheresis group(fresh apheresis platelet),102 cases in the concentration group(manual-concentrationplatelet),112 cases in the frozen group(frozen platelet).The platelet correction index(CCI),the effective rate of platelet transfusion and the adverse reaction rate were detected in the 3 groups.Alanine aminotransferase(ALT),aspartic aminotransferase(AST),total albumin(TP)and alkaline phosphatase(ALP)were compared in the 3 groups.Results There were statistically significant differences in24 hCCI among the 3 groups(Z=15.288,P<0.01).The adverse reaction rate among the 3 groups was statistically significant(χ~2=6.054,P=0.048).There were no statistically significant differences in the biochemical indexes(ALT,AST,TP,ALP)before and after administration of frozen platelets.There were no statistically significant differences in the biochemical indexes of patients with the same disease after the transfusion of different doses of frozen platelets and the changes in biochemical indexes at different periods after the transfusion of same dose of frozen platelets.Conclusion Frozen platelet transfusion is effective,and its preserving solution DMSO has no obvious toxic and side effects on human body,which is worth promoting.
Objective To evaluate the effectiveness of frozen platelet clinical transfusion and the effect of its preserving solution dimethyl sulfoxide(DMSO)on human body.Methods A total of 319 patients who had received platelet infusion in the Affiliated Hospital of Southwest Medical University from January 1,2016 to June 30,2017 and met the inclusion criteria were selected and divided into 3 groups according to different platelet infusion products:105 cases in the apheresis group(fresh apheresis platelet),102 cases in the concentration group(manual-concentrationplatelet),112 cases in the frozen group(frozen platelet).The platelet correction index(CCI),the effective rate of platelet transfusion and the adverse reaction rate were detected in the 3 groups.Alanine aminotransferase(ALT),aspartic aminotransferase(AST),total albumin(TP)and alkaline phosphatase(ALP)were compared in the 3 groups.Results There were statistically significant differences in24 hCCI among the 3 groups(Z=15.288,P<0.01).The adverse reaction rate among the 3 groups was statistically significant(χ~2=6.054,P=0.048).There were no statistically significant differences in the biochemical indexes(ALT,AST,TP,ALP)before and after administration of frozen platelets.There were no statistically significant differences in the biochemical indexes of patients with the same disease after the transfusion of different doses of frozen platelets and the changes in biochemical indexes at different periods after the transfusion of same dose of frozen platelets.Conclusion Frozen platelet transfusion is effective,and its preserving solution DMSO has no obvious toxic and side effects on human body,which is worth promoting.
引文
[1]易晓阳,王艳,韩颖.冰冻血小板低温损伤及防护机制的研究进展[J].中国实验血液学杂志,2014,22(6):1761-1765.
[2]PéREZFERRER A,NAVARROSUAY R,VIEJOLLOR EN-TE A,et al.In vitro thromboelastometric evaluation of the efficacy of frozen platelet transfusion[J].Thromb Res,2015,136(2):348-53.
[3]CROWE J H,TABLIN F,WOLKERS W F,et al.Stabilization of membranes in human platelets freeze-dried with trehalose[J].Chem Phys Lipids,2003,122(1/2):41-52.
[4]刘仁强,秦艳兰,梁兵,等.血小板制品细菌污染风险的研究[J].临床血液学杂志(输血与检验版),2010,23(2):210-213.
[5]Centers for Disease Control and Prevention(DCD).Fatalbacterial infections associated with platelet transfusions United States,2004[J].M M WR Morb Mortal Wkly Rep,2005,54(7):168-170.
[6]丁国良,秦卫胜,赵林园,等.冰冻血小板的关键制备技术及临床应用研究[J].中国实验血液学杂志,2016,24(4):1226-1231.
[7]HULL W F,WOOD D C.Eye effects of DMSO:reportof negative results[J].Northwest Med,1969,68(1):39-41.
[8]JOVANOVIC R,GRUJIC J,RADLOVACKI V,et al.Cryopreservation-challenge of platelet concentrates long time preservation[J].Health MED,2011,5(6):1683-1694.
[9]李卉,邢颜超,刘景汉.临床应用低温保存血小板的8年回顾性研究[J].中国输血杂志,2008,21(11):849-851.
[10]春媛,张楠,庞桂芝,等.血液病患者反复输注冷冻血小板联合冷沉淀的效果观察[J].现代预防医学,2011,38(19):3967-3968.
[11]吴子权.分析机采新鲜血小板与冰冻血小板的临床应用疗效[J].中外医疗,2014(26):54-55.
[12]刘广亚,单桂秋,张雅妮,等.冷冻血小板促进大鼠皮肤创面愈合的研究[J].中国输血杂志,2014,2(27):139-142.
[13]罗光成,易婷婷,刘素兰,等.二甲亚砜对外周血单个核细胞增殖能力和细胞因子分泌功能的影响[J].中国实验诊断学,2014,18(5):711-714.
[14]HOLLEY A,MARKS D C,JOHNSON L,et al.Frozen blood products:clinically effective and potentially ideal for remote Australia[J].Anaesth Intensive Care,2013,41(1):10-19.
[15]LELKENS C C,KONING J G,DE KORT B,et al.Experiences with frozen blood products in the Netherlands military[J].Transfusion,2006,46(9):17.
[2]PéREZFERRER A,NAVARROSUAY R,VIEJOLLOR EN-TE A,et al.In vitro thromboelastometric evaluation of the efficacy of frozen platelet transfusion[J].Thromb Res,2015,136(2):348-53.
[3]CROWE J H,TABLIN F,WOLKERS W F,et al.Stabilization of membranes in human platelets freeze-dried with trehalose[J].Chem Phys Lipids,2003,122(1/2):41-52.
[4]刘仁强,秦艳兰,梁兵,等.血小板制品细菌污染风险的研究[J].临床血液学杂志(输血与检验版),2010,23(2):210-213.
[5]Centers for Disease Control and Prevention(DCD).Fatalbacterial infections associated with platelet transfusions United States,2004[J].M M WR Morb Mortal Wkly Rep,2005,54(7):168-170.
[6]丁国良,秦卫胜,赵林园,等.冰冻血小板的关键制备技术及临床应用研究[J].中国实验血液学杂志,2016,24(4):1226-1231.
[7]HULL W F,WOOD D C.Eye effects of DMSO:reportof negative results[J].Northwest Med,1969,68(1):39-41.
[8]JOVANOVIC R,GRUJIC J,RADLOVACKI V,et al.Cryopreservation-challenge of platelet concentrates long time preservation[J].Health MED,2011,5(6):1683-1694.
[9]李卉,邢颜超,刘景汉.临床应用低温保存血小板的8年回顾性研究[J].中国输血杂志,2008,21(11):849-851.
[10]春媛,张楠,庞桂芝,等.血液病患者反复输注冷冻血小板联合冷沉淀的效果观察[J].现代预防医学,2011,38(19):3967-3968.
[11]吴子权.分析机采新鲜血小板与冰冻血小板的临床应用疗效[J].中外医疗,2014(26):54-55.
[12]刘广亚,单桂秋,张雅妮,等.冷冻血小板促进大鼠皮肤创面愈合的研究[J].中国输血杂志,2014,2(27):139-142.
[13]罗光成,易婷婷,刘素兰,等.二甲亚砜对外周血单个核细胞增殖能力和细胞因子分泌功能的影响[J].中国实验诊断学,2014,18(5):711-714.
[14]HOLLEY A,MARKS D C,JOHNSON L,et al.Frozen blood products:clinically effective and potentially ideal for remote Australia[J].Anaesth Intensive Care,2013,41(1):10-19.
[15]LELKENS C C,KONING J G,DE KORT B,et al.Experiences with frozen blood products in the Netherlands military[J].Transfusion,2006,46(9):17.