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NEJM：重度血小板减少症早产儿血小板输注量研究

2019-01-17 zhangfan MedSci原创

重度血小板减少症早产儿血小板输注
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研究认为，重度血小板减少症的早产儿中，接受血小板计数阈值为50000/立方毫米的血小板输注的患者其不良预后率明显高于接受血小板计数阈值为25000/立方毫米的血小板输注者

血小板输注是预防早产儿血小板减少出血的常用方法，但目前缺乏研究数据以指导输注阈值。

近日研究人员开展多中心研究，月龄小于34周的严重血小板减少新生儿参与，接受治疗至血小板计数阈值为50000/立方毫米(高阈值组)或25000/立方毫米(低阈值组)。研究的主要终点为死亡或大出血。

660名新生儿参与研究，平均体重740g，平均月龄26.6周。在高阈值组，90%的患儿接受至少1次治疗，低阈值组53%的患儿接受至少1次治疗。高阈值组26%的患儿出现主要终点事件，低阈值组仅19%的患儿出现终点事件（OR=1.57）。高阈值组不良事件率为25%，低阈值组为22%（OR=1.14）。

研究认为，重度血小板减少症的早产儿中，接受血小板计数阈值为50000/立方毫米的血小板输注的患者其不良预后率明显高于接受血小板计数阈值为25000/立方毫米的血小板输注者。

原始出处：

Anna Curley et al. Randomized Trial of Platelet-Transfusion Thresholds in Neonates.N Engl J Med， January 17， 2019.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1302807, encodeId=1494130280ec4, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sat Jan 19 07:11:00 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1370282, encodeId=5fad13e028238, content=<a href='/topic/show?id=780c890604f' target=_blank style='color:#2F92EE;'>#血小板输注#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89060, encryptionId=780c890604f, topicName=血小板输注)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=927d310, createdName=hywen7326, createdTime=Sat Jan 19 07:11:00 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358462, encodeId=a22b358462f1, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Thu Jan 17 17:43:06 CST 2019, time=2019-01-17, status=1, ipAttribution=)]
    2019-01-19 lingaifan

    #血小板减少#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1302807, encodeId=1494130280ec4, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sat Jan 19 07:11:00 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1370282, encodeId=5fad13e028238, content=<a href='/topic/show?id=780c890604f' target=_blank style='color:#2F92EE;'>#血小板输注#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89060, encryptionId=780c890604f, topicName=血小板输注)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=927d310, createdName=hywen7326, createdTime=Sat Jan 19 07:11:00 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358462, encodeId=a22b358462f1, content=学习了，涨知识了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Thu Jan 17 17:43:06 CST 2019, time=2019-01-17, status=1, ipAttribution=)]
    2019-01-19 hywen7326

    #血小板输注#

    0

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    2019-01-17 王秀

    学习了，涨知识了！

    0

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