不相同的 ABO 血小板输血,免疫血小板折射性和血小板支持
Min-Hi Han1,2, Krishna Govind Badami2
1Department of Haematology, Christchurch Hospital, Christchurch, New Zealand.
British journal of haematology
|February 29, 2024
概括
ABO非相同 (ABO-ni) 血小板增加了免疫血小板输血折射性 (i-PTR) 的风险. 接受更多ABO-ni血小板的患者经历了i-PTR,并且需要与匹配的血小板提供更长时间的支持.
科学领域:
- 输血医学 输血医学
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
背景情况:
- 免疫血小板输血折射性 (i-PTR) 在患者护理中构成了重大挑战.
- 与ABO非相同的 (ABO-ni) 血小板输血被怀疑是i-PTR的风险因素.
研究的目的:
- 调查 ABO-ni 血小板对 i-PTR 的发生率的影响.
- 为了确定i-PTR的独立风险因素.
- 评估ABO-ni血小板暴露对随后的血小板支持的影响.
主要方法:
- 对接受血小板输血的17322名患者进行了回顾性分析.
- 将i-PTR定义为具有抗HLA-I/HPA阳性的折射性.
- 单变量和多变量分析以确定独立的风险因素.
主要成果:
- 1.1%的患者 (188) 发生了i-PTR.
- 与非耐药患者 (29.5%) 相比,i-PTR患者获得的 ABO-ni 血小板显著增加 (53.2%).
- 对于i-PTR的独立风险因素包括女性性别,年龄≤60岁,血液学诊断和接受≥2个ABO-ni血小板.
- 暴露于ABO-ni血小板的i-PTR患者需要匹配的血小板持续时间更长 (96.5天),而不是仅接受ABO相同血小板 (59.0天).
结论:
- ABO-ni血小板是发展i-PTR的重要风险因素,具有潜在的剂量依赖作用.
- 建议在患有i-PTR风险的患者考虑ABO-相同 (ABO-i) 血小板.
- 了解这些因素可以优化血小板输血策略并改善患者的治疗结果.
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