摘要
目的评价血小板疗效评分(platelet efficacy score,PEscore)对血液病患者血小板输注疗效预测的应用效果。方法纳入2021年1月1日至2024年12月31日开滦总医院拟输注血小板的血液病患者485例,男性298例[(62.09±15.45)岁],女性187例[(59.17±16.52)岁]。收集患者诊断、性别、年龄、血小板输注次数、血小板抗体等临床资料,调查本院血液病患者血小板输注无效率及影响因素,应用ROC曲线评估PEscore预测模型的应用效果。利用115例临床病例验证PEscore模型实际应用效果,计算灵敏度、特异度、准确度。结果485例病例输注无效发生率为29.90%(145/485);血小板输注有效组和无效组间不同诊断[淋巴瘤等,2组分别为55.32%(26/47)、44.68%(21/47)],既往血小板输注次数[≥25次2组分别为60.78%(31/51)、39.22%(20/51)]、血小板抗体检测情况[阳性组2组分别为33.76%(53/176)、66.24%(104/157)]、血小板输注剂计量(×10^(11)/L)[>6组,2组分别为62.71%(74/118),37.29%(44/118)]比较,有统计学差异(P<0.05)。PEscore预测血液病患者血小板输注无效的ROC曲线下面积是0.876,截点、对应的灵敏度和特异度分别为:19、90.59%、69.44%。临床结果提示:PEscore预测模型预测血液病患者血小板输注无效的灵敏度为87.50%、特异度为93.41%、准确度为92.17%。结论血液病患者血小板输注无效率较高,PEscore预测模型对于血液病患者血小板输注疗效的预测效果良好,能够为输血前血液病患者血小板输注效果预测提供可靠依据。
Objective To evaluate the performance of platelet efficacy score(PEscore)in predicting platelet transfusion efficacy in hematological patients.Methods A total of 485 patients with hematological diseases,including 298 males(62.09±15.45 years)and 187 females(59.17±16.52 years)who received platelet transfusion from January 1,2021 to December 31,2024 were enrolled in this study.Clinical data of the patients such as diagnosis,gender,age,number of platelet transfusion,and platelet antibody data were analyzed to investigate the incidence and influencing factors of platelet transfusion refractoriness in hematological patients at our hospital.ROC curve was used to evaluate the performance of PEscore model in predicting platelet transfusion efficacy.The predictive performance of PEscore model was validated by calculating its sensitivity,specificity,and accuracy in 115 clinical cases.Results The incidence of platelet transfusion refractoriness in 485 cases was 29.90%(145/485).Significant differences(P<0.05)were observed between the effective and ineffective platelet transfusion groups regarding the following factors:diagnosis:lymphoma[55.32%(26/47)vs 44.68%(21/47)],the number of previous platelet transfusions[≥25:60.78%(31/51)vs 39.22%(20/51)],platelet antibody screening result[positive:33.76%(53/157)vs 66.24%(104/157)],and platelet transfusion volume(×10^(11)/L)[>6:62.71%(74/118)vs 37.29%(44/118)].The area under the ROC curve of PEscore was 0.876.The cut-off points and corresponding sensitivity and specificity were 19.90.59%and 69.44%,respectively.The results of clinical application showed that the sensitivity,specificity and accuracy of the PEscore model for predicting platelet transfusion were 87.50%,93.41%and 92.17%,respectively.Conclusion The incidence of platelet transfusion refractoriness in hematological patients is relatively high.PEscore prediction model has a good performance in predicting the effect of platelet transfusion,which can provide a reliable basis for predicting the effect of platelet transfusion in hematological patients before blood transfusion.
作者
李君
王澜
谢怡华
陈子奇
赵刚
LI Jun;WANG Lan;XIE Yihua;CHEN Ziqi;ZHAO Gang(Blood Transfusion Branch of Kailuan General Hospital,Tangshan 063000,China;Department of Blood Transfusion,Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi 83000,China)
出处
《中国输血杂志》
2025年第6期797-802,共6页
Chinese Journal of Blood Transfusion
基金
河北省医学科学研究课题计划资助(20231864)。
作者简介
第一作者:李君(1985-),女,副主任技师,Email:27880026@qq.com;通信作者:赵刚,Email:236786791@qq.com。
