摘要：目的 探讨影响血液病患者血小板输注疗效的相关因素。方法 对2014年1至6月在我院输注血小板的132例血液病患者的临床资料进行回顾性分析。以输血后血小板增高指数（CCI值）来评价血小板输注效果，同时对影响血小板抗体阳性率的相关因素如病因、患者性别、输注次数、血型及年龄和影响输注效果的相关因素如抗体强度、血小板种类、保存时间、患者体重及并发症等进行统计学分析。结果  132例血液病患者，抗体总阳性率18.94%，输注1376次，有效率为59.23%；有效组抗体阳性率为8.33%，远低于无效组抗体阳性率31.67%（P<0.05）。不同疾病、输注次数和不同年龄阶段血小板抗体阳性率差异均有统计学意义（P<0.05）。ITP组抗体阳性率最高，随着输注次数的增多,血小板抗体阳性率增高，在三个年龄段中21～40岁年龄段的抗体阳性率最高。血小板抗体的产生与患者性别和血型无关。随着抗体强度和患者体重的增加,血小板输注有效率均降低；辐照机采血小板的输注有效率最高；在同种类型的血液病患者中，无并发症患者的血小板输注疗效明显优于有并发症的患者；血小板保存天数与输注有效率无明显相关性。结论  血液病患者的疾病、年龄、血小板输注次数、血小板抗体的产生、抗体强度、血液成分、体重和并发症对血小板输注均有一定的影响。

Abstract：Objective To investigate the influence factors of platelet transfusion efficiency in patients with hematologic diseases. Methods The clinical and platelet transfusion data in 132 patients with hematologic diseases were retrospectively analyzed. The corrected count of increment (CCI) was used to evaluate the transfusion efficiency. Meanwhile the factors influencing the antibody positive rate such as disease cause, gender, transfusion times, blood type and age, and the factors influencing platelet transfusion efficiency such as antibody strength, platelet sorts, storage time, weight, and complications were statistically analyzed. Results The results showed that the total platelet transfusion efficiency of patients was 59.23%. The antibody positive rate in efficient group (8.33%) was lower than that of inefficient group (31.67%) with statistical different（P<0.05）. There was significantly difference on antibody positive rate among groups of different transfusion times and age（P<0.05）.The antibody positive rate increased with transfusion times, while antibody positive rate in 20-40 years old patients group was the highest. There were no statistical difference on antibody positive rate among the diseases, sex and blood groups. The platelet transfusion efficiency decreased with the increase of the patients’ weight, the platelet transfusion efficiency was better in patients without complications. There was no significant correlation between the antibody strength and storage time of the platelet pre-transfusion with transfusion efficiency. Conclusion The effectiveness of platelet transfusion in patients with the hematologic diseases might be generally affected by transfusion times, anti-platelet antibody production, blood components, patient’s ages and weight, and complications.