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1、活化血浆凝固时间对血小板输注疗效评价的研究【摘要】本研究探讨活化血浆凝固时间(APCT)对评价血小板输注疗效的价值,用血小板聚集凝血因子分析仪检测了20例血液病患者血小板输注前后APCT的变化,并与血小板计数增加校正指数(CCI)和实际血小板回收率(PPR)进行了对比研究。结果表明:输注1小时、24小时后的APCT均明显缩短,APCT由血小板输注前的(103.7±11.3)秒分别缩短为输注后1小时、24小时的(60.0±9.7)秒、(68.5±9.8)秒,(P<0.01),而正常对照的APCT为(42
2、.0±3.4)秒;按照CCI和PPR的判断标准(输注后1小时和24小时CCI分别为<7500和<5000,PPR分别为<30%和20%为输注无效),有2例为血小板输注无效,其输注1小时、24小时的CCI值分别为7415、2966和6913、4988,PPR值分别为28.0%、11.2%和25.2%、14.1%。1例PPR均达血小板输注无效标准,而CCI值均显示血小板输注有效;2例PPR均达血小板输注无效标准,而输注1小时的CCI值表示为血小板输注有效,24小时的CCI值表示为血小板输注无效
3、。结论:APCT可以反映血小板数量和质量的变化,也能较全面的评估血小板的输注疗效。【关键词】活化血浆凝固时间血小板输注血小板TestofActivatedPlasmaClottingTimetoAssessEfficacyofPlateletTransfusionAbstractThestudywasaimedtoinvestigatethevalueofactivatedplasmaclottingtime(APCT)forestimatingtheefficacyofplatelettransfusio
4、ntherapy.Thereweretwentypatientswithhematologicaldiseases,whoreceivedtransfusionofplatelet,involvedinthetest.APCTwasdeterminedbeforeandaftertransfusionofthesepatients,thenAPCTwascontrastedwithcorrespondingCCIandPPR.Theresultsshowedthat1hourand24hourAPCTswe
5、reshortenedobviously.APCTbeforetransfusionwas(103.7±11.3)seconds,butthe1hourand24hourAPCTswereshortenedto(60.0±9.7)secondsand(68.5±9.8)secondsrespectively(P<0.01).AccordingtothejudgingcriteriaofCCIandPPR(CCIandPPRvaluesat1and24hoursaftertransfusionare&l
6、t;7500,<5000and<30%,<20%respectively,thetransfusionisinvalid),twopatientsreceivedinvalidtransfusion.Their1and24hourCCIswere7415,2966and6913,4988respectively.Their1and24hourPPRswere28.0%,11.2%and25.2%,14.1%respectively.Onepatient'sPPRreachedthestan
7、dardofinvalidtransfusion,buthisCCIshowedavalidtransfusionhereceived.Twopatients'PPRreachedthestandardofinvalidtransfusion,buttheir1hourCCIreachedthestandardofvalidtransfusion,andtheir24hourCCIreachedthestandardofinvalidtransfusion.ItisconcludedthatAPCTrefl
8、ectsthevariations5ofquantityandqualityofplateletsimultaneously,andcanevaluatepreciselytheefficacyofplatelettransfusion.Keywordactivatedplasmaclottingtime;platelettransfusion;plateletJExpHematol2007;15(1):108-