中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (27): 5015-5017.doi: 10.3969/j.issn.1673-8225.2010.27.017

• 干细胞移植 stem cell transplantation • 上一篇    下一篇

冰冻单采血小板在外周血干细胞移植中的应用：与输注新鲜单采血小板效果比较

杨孝顺1，谢  琳2，朱鸿杰3，李琳华1，王桂华4   

  1. 1云南省委机关卫生所，云南省昆明市  650032；2云南省肿瘤医院化疗中心，云南省昆明市  650118；3解放军第五三三医院急诊科，云南省昆明市 650224；4解放军昆明总医院成都军区血液中心，云南省昆明市 650032
  • 出版日期:2010-07-02 发布日期:2010-07-02
  • 作者简介:杨孝顺，男，1964年生，四川省南充市人，汉族，2000年解放军第三军医大学毕业，副主任技师，主要从事外周血干细胞移植方面的研究。

Application of frozen single platelet transfusion in peripheral blood stem cell transplantation: Comparison with fresh single platelet transfusion

Yang Xiao-shun1, Xie Lin2, Zhu Hong-jie3, Li Lin-hua1, Wang Gui-hua4   

  1. 1 Health Center, Yunnan Provincial Committee Organizations, Kunming  650032, Yunnan Province, China;2 Chemotheray Center, Yunnan Provincial Cancer Hospital, Kunming  650118, Yunnan Province, China; 3 Department of Emergency, 533 Hospital of Chinese  PLA, Kunming  650224, Yunnan Province, China; 4 Department of Blood Center, Kunming General Hospital of Chengdu Military Area Command of Chinese PLA, Kunming  650032, Yunnan Province, China
  • Online:2010-07-02 Published:2010-07-02
  • About author:Yang Xiao-shun, Associate chief technician, Health Center, Yunnan Provincial Committee Organizations, Kunming 650032, Yunnan Province, China

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摘要：

背景：由于实行义务献血后血小板来源紧张，输注新鲜单采血小板有时难以保证。而冰冻单采血小板有较好的即刻止血效果，可用于各种低血小板患者的止血。
目的：探讨冰冻单采血小板输注在外周血干细胞移植中的替代疗效。
方法：44例血液病或淋巴瘤患者均接受外周血干细胞移植，血小板计数低于40×109 L-1，随机分为新鲜血小板组、冰冻血小板组，22例/组。外周血干细胞移植后0~14 d，新鲜血小板组患者直接输注经专用白细胞滤器过滤后的新鲜单采血小板；冰冻血小板组患者将同型冰冻单采血小板取出后，放入37 ℃水浴迅速融化，用白细胞滤器过滤后，于40 min内输注。一般每3 d输注1次，10 U/次，共输入3~16次，输入次数根据患者出血情况酌情增减。
结果与结论：与新鲜血小板组比较，冰冻血小板组输注后24 h血小板及凝血四项指标无明显变化(P > 0.05)；输注后48 h血小板计数显著降低(P < 0.01)；输注后72 h出血时间、凝血酶原时间、活化部分凝血活酶时间及血小板计数均显著降低(P < 0.05或 P < 0.01)，凝血酶时间及纤维蛋白原无明显差异(P > 0.05)。建议在外周血干细胞移植中，应用冰冻单采血小板防止出血输注时间为2 d输注1次。

关键词: 血小板输注, 冰冻血小板, 外周血干细胞移植, 出血/止血, 干细胞

Abstract:

BACKGROUND: Because voluntary blood donation in China leads to blood shortage, a large number of fresh single platelets are sometimes difficult to guarantee. Frozen single platelets have immediate hemostatic effect for patients who are in the low state platelets with bleeding.
OBJECTIVE: To study the effect of frozen single platelet transfusion on peripheral blood stem cell transplantation.
METHODS: A total of 44 patients with hematopathy or lymphoma were subjected to peripheral blood stem cell transplantation, and platelet was less than 40×109 /L. These patients were randomly assigned to frozen single platelets group and fresh single platelets group (n = 22). At 0-14 days following transplantation, patients in the fresh single platelets group were directly infused with fresh single platelets following leukocyte filtration. Homotype frozen single platelets were obtained from patients in the frozen single platelets group, and then placed in a water bath at 37 ?C for rapid thawing. Following filtration using leukocyte filter, infusion was conducted within 40 minutes; once every 3 days,  10 U/time, for totally 3-16 times. The time of infusion depended on bleeding of patients.
RESULTS AND CONCLUSION: No significant difference in platelet and four items of blood coagulation was detected between fresh single platelets group and frozen single platelets group at 24 hours following infusion (P > 0.05). Blood platelet count was significantly decreased at 48 hours following infusion (P < 0.01). Bleeding time, prothrombin time, activated partial thromboplastin time and platelet count were significantly reduced at 72 hours following infusion ( P < 0.05 or P < 0.01). There were no significant differences in thrombin time and fibrinogen (P > 0.05). It is suggested that the time of frozen single platelet transfusion to prevent bleeding in peripheral blood stem cell transplantation should change into every 2 days.

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