目的 探讨利用微信群保留机采血小板无偿献血者的应用效果。方法 从本血站穿越安全输血标准化管理系统中调取2015年1月1日—2018年12月31日捐献机采血小板无偿献血者信息,根据初次捐献机采血小板后是否自愿加入机采微信群的机采血小板无偿献血者分为实验组和对照组,统计分析各组机采血小板无偿献血者重复献血 2～3 次和≥4 次以上机采血小板无偿献血者人数及平均献血次数。结果 2015—2018年间机采血小板采集量、献血人数及平均献血次数逐年上升;重复献血 2～3 次和≥4 次以上人数,实验组均高于对照组,机采血小板平均献血次数实验组均高于对照组,其中2016年和2018年实验组机采血小板平均献血次数高于对照组(P<0.05)。结论 通过机采微信群预约与管理机采血小板无偿献血者可提高机采血小板招募的工作效率,有效扩大和稳定机采血小板无偿献血者固定队伍。

目的 探讨影响初次机采血小板献血者再次捐献的相关因素,为制定机采献血者保留策略提供依据。方法 选择2016年1月1日—2016年12月31日在广州血液中心首次成功捐献机采血小板的13 899例献血者为研究对象,分析每个献血者献血时性别、年龄、文化程度、是否发生献血不良反应与下一年度是否再次捐献机采血小板的相关性。结果 男性献血者再次捐献率(10.68%)高于女性献血者再次捐献率(8.94%),差异有统计学意义(P＜0.01);献血者年龄18～25岁组再次捐献率最高为12.86%,46～60岁组再次捐献率最低为6.46%,差异有统计学意义(P＜0.001);献血者文化程度高中或职中组再次捐献率最高为11.23%,本科或以上组再次捐献率最低为8.94%,差异有统计学意义(P＜0.001);未发生不良反应献血者再次捐献率(10.37%)高于发生不良反应献血者再次捐献率(5.56%),差异有统计学意义(P＜0.01)。结论 男性、年龄较小、文化程度较低和未发生献血不良反应的献血者更愿意返回再次捐献机采血小板,对这部分献血者采取针对性保留措施,有利于建立起一支固定捐献机采血小板的献血者队伍。

Objective To explore the related factors affecting the re-donation of the first apheresis platelet donors, and to provide a basis for the retention strategy. Methods A total of 13 899 blood donors who successfully donated apheresis platelets for the first time in Guangzhou Blood Center from January 1, 2016 to December 31, 2016 were selected as subjects. The correlation among gender, age, education level, adverse reactions of blood donation and whether platelet collection was re-donated in the next year was analyzed. Results Re-donation rate of male blood donors (10.68%) was higher than that of female blood donors (8.94%). The difference was statistically significant (P<0.01). Re-donation rate of blood donors aged 18～25 was the highest 12.86%, and that of 46～60 was the lowest 6.46%. The difference was significant (P<0.001). Re-donation rate of high school or vocational college blood donors was the highest 11.23%. The lowest re-donation rate was 8.94% in the undergraduate group or above, and the difference was statistically significant (P< 0.001). The re-donation rate of donors without adverse reactions (10.37%) was higher than that of donors with adverse reactions (5.56%). The difference was statistically significant (P<0.01). Conclusion Male, younger, less educated and no adverse reactions to blood donation are more willing to return to donate platelet again. Targeting these donors for reserve measure will conducive to the establishment of a fixed platelet donor team.

目的 分析2016—2018年度广州市单采血小板报废的主要原因,并探讨如何降低单采血小板报废率。方法 统计2016—2018年度广州市单采血小板的采集量、报废数量和报废率等相关数据,分析报废原因,提出相应改进措施。结果 2016—2018年广州血液中心单采血小板总报废率为1.13%,三年的报废率逐年下降。报废的最主要原因为血液感染因子筛查不合格或ALT异常,占总报废率64.44%;其次分别为血量不足(占比14.4%)、采血耗材/血袋/热合口漏(占比11.01%)等。结论 我中心单采血小板报废率虽逐年下降,但仍需加强献血前宣传,动员更多的健康适龄公民参加无偿献血,同时重视采前血液感染因子的筛查工作、采血前及采血过程的护理干预、设备维护保养和产品处理能力的培训,进一步有效降低血液报废率。

Objective To analyze the main causes of apheresis platelets discarding in Guangzhou from 2016 to 2018, and discuss how to reduce the discarding rate. Methods Collected the data of apheresis platelets collection, the discarding number and the discarding rate in Guangzhou from 2016 to 2018,to analysis the reasons of apheresis platelets discarding and introducing improvement measures. Results From 2016 to 2018, the total discarding rate of apheresis platelets collected from Guangzhou Blood Center was 1.13%. In the three years,the discarding rate declined year by year.The main reasons for apheresis platelets discarding were the result of blood infection factor test or ALT was not qualified, accounting for 64.44% of the total scrapping rate. Then followed by insufficient blood volume (14.4%) and Blood consumables/blood bags/heat closure leakage (11.01%). Conclusion Although the rate of apheresis platelet discarding in Guangzhou Blood Center is decreasing year by year, we still need to enhance blood donation propaganda, mobilize more healthy citizens to participate in blood donation, and pay attention to the screening of blood infection factors before blood collection, nursing blood donor before and during blood collection, and training of ability in equipment maintenance and product handling, so as to further effectively reduce the rate of blood discarding.

目的 观察利妥昔单抗在治疗造血干细胞移植后血小板输注无效的有效性和安全性。方法 回顾分析我院2014年1月—2017年6月收治的11例利妥昔单抗治疗的造血干细胞移植后血小板输注无效的病例资料,其中包括重型地中海贫血8例,急性髓系白血病1例,重型再生障碍性贫血2例。结果 10例造血干细胞移植后血小板输注无效患者经利妥昔单抗治疗,375 mg/m²,每周1次,2~3次后血小板输注无效的状况明显改善;1例造血干细胞移植后血小板输注无效患者接受1次利妥昔单抗治疗,仍存在血小板输注无效,最终因颅内出血死亡。结论 利妥昔单抗是治疗造血干细胞移植后血小板输注无效的一种很有效的治疗方法。

Objective The purpose of our study was to evaluate the efficacy and safety of rituximab in the treatment of platelet transfusion refractoriness after hematopoietic stem cell transplantation. Methods We retrospectively analyzed 11paitents （8 thalassemia major,2 sever aplastic anemia,and 1 acute myeloid leukemia） with platelet transfusion refractoriness after hematopoietic stem cell transplantation. All 11 patients received treatment of rituximab. Results 10 of 11 platelet transfusion refractoriness patients after hematopoietic stem cell transplantation had improvement of platelets transfusion,1 patient of 11 platelet transfusion refractoriness patients had no response and died of intracranial hemorrhage. Conclusion Rituximab is a promising treatment in patients with platelet transfusion refractoriness after hematopoietic stem cell transplantation.

目的 探讨机采血小板献血者流失原因,为建立一支稳固的机采血小板献血者队伍提供参考。方法 选择2009年1月1日—2012年12月31日河源市中心血站首次机采血小板献血者共382例为研究对象,根据其首次机采血小板献血后3年内是否再次参加机采血小板献血分为实验组和对照组,分别对研究对象进行电话回访调查。结果 3年内未再次参加血小板献血流失者118例,总流失率为30.89%;不同献血动机组流失率差异有统计学意义 (χ²= 18.552,P=0.000),其中动机不明确组流失率(52.49%)最高,寻求社会荣誉组流失率(15.79%)最低。发生过献血反应组(63.64%)流失率显著高于未发生献血反应组流失率(26.63%),两组间差异有统计学意义(χ²=8.501,P=0.004);对献血过程不满意组流失率(39.77%)显著高于满意组流失率(28.23%),两组间差异有统计学意义(χ²=16.413,P=0.000);认为机采时间过长组机采血小板献血者流失率(49.40%)显著高于不认为机采时间过长组流失率为(25.75%),两组间差异有统计学意义(χ²=17.014,P=0.000)。健康状况(体检结果)不合格组流失率(43.84%)显著高于合格组流失率(27.83%),两组间差异有统计学意义(χ²=9.022,P=0.030)。媒体(或网络)负面的宣传与献血者是否方便对机采血小板献血者流失率的影响不显著(χ²=1.579,P=0.209;χ²=2.130,P=0.144)。结论 机采血小板献血者流失主要与献血动机、献血过程感受以及自身健康等因素有关。

目的 探讨卵巢上皮性癌患者治疗前后外周血血小板计数(PLT)变化的临床意义。方法 采用全血细胞自动分析仪检测115例卵巢上皮性癌患者治疗前和经过有效治疗后的97例患者血小板计数增多检出率的比较,并分析卵巢上皮性癌患者治疗前血小板计数增多与临床病理因素的相关性。结果 33.04％卵巢上皮性癌患者治疗前伴有血小板计数增多,经过有效治疗后,血小板计数增多者降为9.28%,较治疗前明显下降,差异有统计学意义(P<0.05)。卵巢上皮性癌患者治疗前血小板增多与FIGO分期、残余肿瘤灶直径、腹水细胞学和临床疗效相关(P＜0.01)。结论 血小板作为一种简单、经济、灵敏的临床常用指标,监测其表达对于预测卵巢癌临床疗效和预后评估具有临床价值。

目的 探讨CYP2C19不同基因分型对急性冠状动脉综合征(ACS)患者服用氯吡格雷后血小板聚集率的影响。方法 选取2015年1月—2016年3月入住心内科的ACS患者258例为研究对象。入院时及服用氯吡格雷三日后分别抽取静脉血检测血小板聚集率及CYP2C19基因型。结果 快代谢型组(extensive metabolisers, EM)和中代谢型组(intermediate metabolisers, IM)服药前后血小板最大聚集率分别为(58.76±15.45)% vs(35.17±10.26)%和(59.35±11.58)% vs(47.66±12.59)%(P<0.05), 而慢代谢型组(poor metabolisers, PM)的血小板最大聚集率无明显降低。快代谢型组的最大血小板聚集率的降低幅度比慢代谢型组大(23.58±12.39% vs 11.65±13.56%,P<0.05)。 共有33例(12.79%)患者为氯吡格雷抵抗, 其中快代谢型组中氯吡格雷抵抗者2例(1.67%), 中代谢型组中氯吡格雷抵抗者3例(2.80%), 慢代谢型组中氯吡格雷抵抗者28例(90.32%) (三组比较P=0.038)。结论 ACS患者CYP2C19基因分型与服用氯吡格雷后血小板最大聚集率有关,与氯吡格雷抵抗有关。

Objective To explore the relationship between platelet aggregation rate and CYP2C19 gene polymorphisms. Methods A total of 258 cases diagnosed as acute coronary syndrome (ACS) from January 2015 to March 2016. The platelet aggregation rate was tested before and 3 days after taking clopidogrel. CYP2C19 gene polymorphisms was tested by Gene chip hybridization technique. Results The platelet aggregation rate before and after taking clopidogrel was(58.76±15.45)% vs(35.17±10.26)% and(59.35±11.58)% vs(47.66±12.59)%(P<0.05)in EM group and IM group. But there was no change in PM group. The PM group were associated with a significant increase risk of clopidogrel resistance compared with EM group and IM group. Conclusion CYP2C19 gene polymorphisms influence the rate of platelet aggregation rate after taking clopidogrel and are associated with clopidogrel resistance in ACS patients.

目的 探讨影响机采双份血小板质量的因素,以提高机采血小板的制品质量。方法 收集本站2014年3月—9月机采双份血小板献血者资料,观察分析其一般情况,血细胞分离机运行参数及采前血常规对血小板采集质量的影响。结果 采集前血小板计数是影响机采双份血小板质量的重要因素,与血小板采集量成正相关(P<0.05)。而血小板平均体积、血小板体积分布宽度、大血小板比率则与血小板采集量成负相关(P<0.05)。结论 需正确分析献血者采前血常规,作出最优选择,保证机采双份血小板质量。

       目的   探讨口服铁剂方法用于改善铁缺乏的男性机采血小板固定献血者铁营养状况效果，为采供血机构完善无偿献血者关爱策略提供数据支持。方法   选择2022年9月—2023年8月珠海市中心血站男性血小板固定献血者进行铁蛋白（FER）检测。以FER＜30 ng/mL为铁缺乏的判定标准。将49名铁缺乏的男性机采血小板固定献血者随机分成干预组、对照组，分别进行口服铁剂干预，比较两组干预前后血红蛋白（Hb）、血清铁（SI）、FER的浓度变化情况。结果   共检测205名男性机采固定献血者，其中49名FER＜30 ng/mL（铁缺乏组），占23.90%，其Hb、SI、FER均值低于FER≥30 ng/mL男性机采固定献血者（正常组）。49名铁缺乏的机采固定献血者口服铁剂干预后：干预组SI、FER浓度分别为（15.97±5.14）μmol/L、（30.55±14.42）ng/mL，高于对照组［（11.49±4.02）μmol/L、（12.77±5.86）ng/mL）］，其差异有统计学意义（t=3.466，P＜0.001；t=5.493，P＜0.001）。干预组Hb为（143.42±10.85）g/L，高于对照组的（140.88±12.97）g/L，但差异无统计学意义（t=-0.726，P=0.471）。结论   针对铁蛋白低值的机采男性固定献血者，采取口服铁剂方法可以有效改善其铁缺乏状况。

       Objective  To explore the effect of oral iron  supplements on improving iron  deficiency in male  regular plateletpheresis donors．Methods  Male regular plateletpheresis donors from Zhuhai Blood Central Station were selected for ferritin（FER）detection．Using FER＜30 ng/mL as the criterion for determining iron deficiency，49 donors were selected as the study subjects and divided into intervention group and control group，and the changes in hemoglobin（Hb），serum iron（SI），andFER concentrations were compared．Results  A total of 205 male regular plateletpheresis donors underwent FER detection，of which 49 donors had FER under 30 ng/mL（iron deficiency group），accounting for 23.90%．The mean Hb，SI，and FER levels in the iron deficiency group were significantly lower than those with FER≥30 ng/mL．After oral iron intervention，the SI and FER levels in the intervention group（［15.97±5.14］ μmol/L，［30.55±14.42］ ng/mL）were significantly higher than those in the control group（［11.49±4.02］ μmol/L，［12.77±5.86］ ng/mL），and the difference were statistically significant（t=3.466，P＜0.001；t=5.493，P=0.000）．The Hb values of the intervention group and the control group were（143.42±10.85）g/L and（140.88±12.97）g/L，respectively，with no statistically significant difference between the groups（t=-0.726，P=0.471）．Conclusions  Oral iron supplementation can effectively improve iron deficiency in male regular plateletpheresis donors．