Analysis of difference of effect of blood donors on mechanical platelet transfusion
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摘要: 目的 探讨机采血小板献血者对血小板输注疗效的影响差异，为献血者科学、有效、合理的献血以及血小板输注提供参考依据。方法 选取2023年1月—12月医院血液科血小板输注患者，追溯血小板献血者信息，分别从献血者的性别、年龄和献血次数3个方面统计分析数据，统计患者输注血小板前后血小板、白细胞计数的改变和输注后24 h血小板校正增加(CCI)值、24 h血小板回收率(PPR)的数据差异，对血小板输注疗效进行对比。结果 ① 男性献血者捐献的机采血小板，患者输注后，血小板计数由(14.98±13.75)×109/L上升至(30.51± 20.51)×109/L，血小板增量(15.43±15.74)×109/L，明显高于输注女性献血者血小板增量(11.08±12.30)×109/L，差异有统计学意义(P < 0.05)。②男性献血者捐献的机采血小板，24 h CCI、24 h PPR均高于女性献血者，但差异无统计学意义(P＞0.05)；男性献血者血小板输注予女性患者，有效输注率最高，分别为73.68%/64.47%(CCI/PPR)，女性献血者血小板输注予男性患者，有效输注率最低，分别为55.32%/51.06%(CCI/PPR)。③献血者不同年龄段、不同献血次数的血小板，患者输注后在血小板增量、24 h CCI、24 h PPR上均差异无统计学意义(P>0.05)。结论 献血者不同年龄段、不同献血次数采集的血小板，对临床血小板输注疗效影响较小。男性献血者血小板输注疗效高于女性献血者，若患者血小板输注疗效欠佳，建议可选择男性献血者血小板进行输注。Abstract: Objective To investigate the difference of the effect of mechanical platelet donors on platelet transfusion, and provide a reference for scientific, effective and reasonable blood donation and platelet transfusion.Methods Patients with platelet transfusion in the Department of Hematology of the hospital from January to December 2023 were selected, and the information of platelet donors was traced. The data were statistically analyzed from the aspects of gender, age and blood donation times of donors. The changes of platelet and white blood cell counts before and after platelet transfusion, the differences of platelet count increase index(CCI) and 24 h platelet recovery rate(24 h PPR) after transfusion were statistically analyzed, and the curative effect of platelet transfusion was compared.Results ① The platelet count of male donors increased from (14.98±13.75)×109/L to (30.51±20.51)×109/L, and the platelet increment was (15.43±15.74)×109/L. The platelet increment was significantly higher than that of female transfusion donors (11.08±12.30)×109/L, the difference was statistically significant(P < 0.05). ② The 24 h CCI and 24 h PPR of mechanically collected platelets donated by male blood donors were higher than those of female blood donors, but there was no significant differences(P>0.05). The effective transfusion rate of male blood donors to female patients was the highest, 73.68%/64.47%(CCI/PPR), while the effective transfusion rate of female blood donors to male patients was the lowest, 55.32%/51.06%(CCI/PPR). ③There were no significant differences in platelet increment, 24 h CCI and 24 h PPR among blood donors of different ages and different blood donation times after transfusion(P>0.05).Conclusion The platelet collected from blood donors at different ages and blood donation times had little influence on clinical platelet transfusion efficacy. Platelet transfusion in male blood donors may be more effective than that in female blood donors. If the therapeutic effect of platelet transfusion in patients is poor, it is recommended to choose male blood donors for platelet transfusion.
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Key words:
- blood donors /
- platelet collection by machine /
- infusion effect
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表 1 献血者性别对血小板输注疗效影响
指标 性别 P 男 女 献血者信息 例数/例 191 74 年龄/岁 39±12 42±11 >0.05 献血次数/次 5.08±4.51 4.71±3.84 >0.05 患者信息 年龄/岁 45±19 42±19 >0.05 体表面积/m2 1.60±0.15 1.63±0.16 >0.05 输注前血小板/(×109/L) 14.98±13.75 13.61±8.00 >0.05 输注后血小板/(×109/L) 30.51±20.51 24.69±13.98 < 0.051) 血小板增量/(×109/L) 15.43±15.74 11.08±12.30 < 0.052) 白细胞增量/(×109/L) 0.21±1.93 0.11±1.58 >0.05 24 h CCI/% 68.59(131/191) 56.76(42/74) >0.05 男 65.22(75/115) 55.32(26/47) >0.05 女 73.68(56/76) 59.26(16/27) >0.05 24 h PPR/% 61.26(117/191) 52.70(39/74) >0.05 男 59.13(68/115) 51.06(24/47) >0.05 女 64.47(49/76) 55.55(15/27) >0.05 1)t=2.247；2)t=2.382。 
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表 2 献血者年龄对血小板输注疗效影响
指标 年龄/岁 P 18~30 31~50 ≥51 献血者信息 例数/例 107 105 53 献血次数/次 2.92±3.53 5.29±4.141) 8.49±3.752) < 0.05 患者信息 年龄/岁 42±19 45±18 47±18 >0.05 体表面积/m2 1.60±0.15 1.61±0.15 1.61±0.15 >0.05 输注前血小板/(×109/L) 14.44±11.54 15.74±14.99 12.64±7.41 >0.05 输注后血小板/(×109/L) 28.42±17.34 30.47±21.85 26.70±16.39 >0.05 血小板增量/(×109/L) 13.80±15.99 14.72±14.41 14.06±14.12 >0.05 白细胞增量/(×109/L) 0.02±1.99 0.09±1.90 0.40±1.32 >0.05 24 h CCI/% 63.55(68/107) 66.67(70/105) 66.04(35/53) >0.05 24 h PPR/% 56.07(60/107) 60.95(64/105) 60.38(32/53) >0.05 与18~30岁组比较，1)t=4.465，P < 0.05；与31~50岁组比较，2)t=9.195，P < 0.05。
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表 3 献血者献血次数对血小板输注疗效影响
指标 献血次数/次 P 1 2~6 ≥7 献血者信息 例数/例 113 59 93 年龄/岁 29±9 43±11 43±11 < 0.05 患者信息 年龄/岁 45±19 42±19 44±18 >0.05 体表面积/m2 1.61±0.16 1.61±0.15 1.60±0.14 >0.05 输注前血小板/(×109/L) 15.15±15.29 13.76±8.67 14.45±10.41 >0.05 输注后血小板/(×109/L) 28.69±21.66 29.97±19.00 28.44±15.62 >0.05 血小板增量/(×109/L) 13.30±14.65 16.20±17.35 13.99±13.71 >0.05 白细胞增量/(×109/L) 0.25±1.90 0.31±0.99 0.46±2.10 >0.05 24 h CCI/% 65.49(74/113) 64.41(38/59) 65.59(61/93) >0.05 24 h PPR/% 58.41(66/113) 57.63(34/59) 60.22(56/93) >0.05
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