【摘要】 目的探讨血小板减少出血时,C反应蛋白(CRP)含量及输血前静脉注射地塞米松对输注血小板疗效的影响。方法观察45例无发热、脾肿大和弥散性血管内凝血(DIC)的白血病、再障、实体瘤化疗后,因出血需输注血小板的患者,根据CRP值分为CRP正常组和CRP增高组,各组再分地塞米松组(输血前静脉注射地塞米松10mg)和非地塞米松组。每例在输血前、输血后12～16h检测外周血小板计数(CRP)和临床出血。分析CRP及输血前静脉注射地塞米松后对输血小板效果的影响。结果输血小板后,外周血小板计数增加,在CRP正常组高于CRP增高组,分别为(33.2±9.2)×109/L和(25.4±10.4)×109/L,两者差值的差异有统计学意义(t值为4.42,P<0.01)。在CRP增高组中,地塞米松组的患者较非地塞米松组能显著提高外周血小板计数,分别为(30.8±9.4)×109/L和(20.3±10.0)×109/L,两组差值的差异有统计学意义(t值为3.53,P<0.01)。临床出血改善率达76%。结论CRP高是影响血小板输注效果的又一因素,对CRP增高的患者,输血前静脉注射地塞米松能提高血小板输注的效果。更多还原

【Abstract】 Objective To study dexamethasone and higher C-reactive protein(CRP) on effects of platelets concentrates(PC) transfusion for bleeding patients with thrombocytopenia.Methods To investigate peripheral blood platelets count,clinical bleeding before(CRP test simultaneously) and 12～16 hours after PC transfusion for 45 non-fever,non-splenomegaly and non-DIC(disseminated intravascular coagulation,DIC) patients with leukemia,aplastic anemia,or solid tumor chemotherapy,which had bleeding and needed PC transfusion.All cases were divided into two groups:CRP normal and CRP higher one according to their CRP results.Each group were also classified as non-dexamethasone and dexamethasone division(10mg dexamethasone intravenous injection before transfusions) respectively,in order to analyze the relationships between effects of PC transfusion and serum levels of CRP or dexamethasone.Results The peripheral blood platelets counts (33.2±9.2)×109/L after PC transfusions in CRP normal group were more than that (25.4±10.4)×109/L,in CRP higher group,with significant differences(t=4.42,P<001).In CRP higher group,the count of dexamethasone division was (30.8±9.4)×109/L,more than that (20.3±10.0)×109/L of non-dexamethasone one,their differences owning statistic significance(t=3.53,P<0.01).Improving rate of clinical bleeding was 76%.Conclusion Higher CRP is another influential factor of PC transfusion.In higher CRP cases,10mg dexamethasone intravenous injection before transfusions can improve PC transfusion effects.更多还原