未成熟血小板分数对化疗患者输注血小板的预测作用

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摘要目的：通过检测外周血的未成熟血小板分数（IPF%）了解骨髓生成释放血小板（PLT）的能力，以期预测化疗患者是否需要输注PLT，避免不必要的PLT输注。方法：收集温州医科大学附属第二医院化疗住院患者186例，其中输血组74例、未输血组112例，利用SYSMEX XE-5000全自动血液分析仪的网织红细胞通道检测患者血常规标本的IPF%、IPF及PLT等指标，比较输血组和未输血组各检测指标的差异。接着对输血组患者的血小板和IPF%进行动态观察，并利用ROC曲线评价各项指标预测是否需输注PLT的效果。结果：输血组的IPF% [5.10%（2.48%，10.68%）]高于未输血组的IPF% [1.85%（1.20%，3.50%）]，差异有统计学意义（P＜
0.05）。而输血组的PLT [35.00×109/L（12.75×109/L，123.75×109/L）]低于未输血组[150.50×109/L（94.75×109/L，209.00×109/L）]，差异有统计学意义（P＜0.05）。动态结果分析发现IPF%随着PLT的下降而升高。通过ROC曲线分析发现IPF%的AUC和PLT的AUC没有差异。结论：IPF%升高提示外周血中PLT破坏增加，但尚无法作为化疗患者是否需输注PLT的预测指标。

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	郭晶晶
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	潘素贞
	周莲莲
	江明华

关键词 ：未成熟血小板分数, 输注血小板, 化学治疗

Abstract：Objective: To investigate whether immature platelet fraction (IPF%) predicate imminent platelet recovery after chemotherapy for the cancer patients, so that unnecessary platelet transfusion can be avoided. Methods: A total of 186 patients were enrolled and divided into blood transfusion group and non-transfusion group. IPF% of anticoagulated blood with EDTA-K2 was evaluated by means of the IPF master program equipped with SYSMEX XE-5000. The differences between IPF% and PLT of blood transfusion group were analyzed dynamically. The ROC curve was performed to evaluate the effect of those indictors in predicting whether PLT transfusion was needed. Results: The IPF% in the blood transfusion group [5.10% (2.48%, 10.68%)] was higher than that in the non-transfusion group [1.85% (1.20%, 3.50%)], and the blood platelet count in the blood transfusion group [35.00×109/L (12.75×109/L, 123.75×109/L)] was lower than in the non-transfusion group [150.50×109/L(94.75×109/L, 209.00×109/L)] (P<0.05). There was an increase of IPF% during PLT nadir. The results of ROC analysis demonstrated that there was no statistical difference between the AUC of PLT and IPF%. Conclusion: Increased IPF% indicates PLT destruction in peripheral blood, but IPF% measurement lacks the predictive power regarding imminent PLT recovery in cancer patients. Therefore decisions regarding prophylactic PC transfusions should not be based on this parameter.

Key words： immature platelet fraction platelet transfusion chemotherapy

收稿日期: 2018-08-01

基金资助:温州医科大学附属第二医院2018年度“育苗计划”（911396）。

通讯作者: 江明华，教授，Email：minghua93@126.com

作者简介: 郭晶晶（1988-），女，浙江温州人，技师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I12/925

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