臺灣博碩士論文加值系統

持續長久捐助分離術血小板(Apheresis Platelet;PH)的捐血者是捐血中心服務腫瘤、血液疾病等病患醫療資源的重要來源。依台南捐血中心為例，PH捐血者年捐量約需36,013 unit才足供醫院病患輸用。在捐PH前均需執行一般血液檢查以判別是否符合捐分離術血小板的條件。但這些熱誠無私奉獻之捐助者累積長久的付出後，在骨髓造血機能是否會有所變化及對所捐助之血品是否會影響輸血療效品質，這議題值得我們關注捐助分離術血小板者之血小板生理變化及所捐助之血品得以如預期的確保輸血功效。
本研究採隨機取樣、回顧性橫斷式研究。以首捐全血(或6個月內未曾捐血者)30例為對照組。以持續1次/2周之PH捐血者為研究組，再依1-5年為間距分為5組。經簽屬IRB審查之研究對象同意書者始為研究對象，以執行檢測PVI之變化，分析探討長久持續捐分離術血小板者之血小板質量變化差異。並將所捐之血品取樣留置於第3天與第5天分析PVI，以探討保存期間血品之變化情形。以one-way ANOVA(SPSS 18.0) ，(95%CI、p＜0.05)執行統計分析。
結果發現捐1 unit PH之研究組與對照組之PVI並無顯著差異。捐2 unit PH之研究組與對照組PVI則有顯著性差異。在血小板儲存活性中，第五天的平均血小板計數比第三天低，而在儲存到第五天的PVI等項均較第三天高且有顯著性差異。
本研究建議分離術捐血者不宜鼓勵持續間距二周捐血，以確保捐血者健康及永續捐血之義舉。在保存期間之變化中得知血小板yield data與MPV呈現反比關係，仍因保存期間會導致血小板細胞膨脹而變大所致。建議現常規於末效期需檢測pH外亦可增測PVI以佐證血小板之yield Quility Control，以確保病患輸血品質。

Blood donors who continue to use long-term donor platelets (Apheresis Platelet; PH) are important sources of medical resources for blood donors to serve patients with cancer and blood diseases. For example, according to the Tainan Blood Center, the annual donation of PH donors is about 36,013 units for hospital patients to use. A general blood test is performed before the donation of the PH to determine whether the conditions for the platelet separation are met. However, after the long-term efforts of these dedicated and selfless donors, whether the bone marrow hematopoietic function will change and whether the blood donated will affect the quality of transfusion efficacy, this issue deserves our attention to the platelet physiology of donors. Changes and donated blood products ensure blood transfusion efficiency as expected.
This study used random sampling and retrospective cross-sectional studies. Thirty patients who received the first blood donation (or no blood donor within 6 months) served as the control group. The PH donors who continued for 1 time/2 weeks were used as the study group, and then divided into 5 groups according to the interval of 1-5 years. Subjects who were examined by the IRB for review were initially included in the study to perform changes in the detection of PVI, and to analyze differences in platelet quality changes in patients with long-lasting continuous donor thrombectomy. Samples of the donated blood samples were left on day 3 and day 5 to analyze the PVI to investigate changes in blood during storage. Statistical analysis was performed with one-way ANOVA (SPSS 18.0), (95% CI, p < 0.05).
The results showed that there was no significant difference in the PVI between the study group and the control group. There was a significant difference between the study group donated 2 unit PH and the control group PVI. In the platelet storage activity, the average platelet count on the fifth day was lower than that on the third day, and the items such as PVI stored on the fifth day were higher than the third day and there was a significant difference.
This study suggests that blood donors should not encourage continuous blood donation for two weeks to ensure the health of the donors and the continued blood donation. It is known that the platelet
yield data is inversely related to MPV during the change of the preservation period, and is still caused by the expansion of platelet cells during storage. It is recommended that the PVI be tested in addition to the pH at the end of the period to support the platelet's yield Quility Control to ensure the patient's blood transfusion quality.

致謝................................................................ii
中文摘要............................................................iii
英文摘要.............................................................iv
壹、導論.............................................................1
貳、文獻探討...........................................................5
參、研究目的...........................................................8
肆、材料與方法.........................................................11
伍、結果..............................................................14
陸、討論與結論.........................................................17
柒、參考文獻...........................................................21
捌、表................................................................25
玖、圖................................................................29
拾、附表..............................................................34
拾壹、附圖............................................................37

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