慢性病患者红细胞输注效果与免疫系统变化的关系分析

Analysis on relation between chronic disease patient' immune system changes and red blood cell transfusion effect

目的:探讨红细胞输注无效的慢性病患者体内血清免疫球蛋白IgG、IgA、IgM以及补体C3、C4的含量与输血效果之间的关系。方法:采用酶联免疫法测定慢性再生障碍性贫血(CAA)、肝癌和肺癌患者中试验组和对照组输血前、后血清IgG、IgA、IgM以及补体C3、C4的含量。结果:试验组、对照组各26名,研究对象为CAA患者、肝癌和肺癌患者,CAA患者试验组和肝癌患者试验组输血后5d的IgG和IgA有升高表现(P<0.05),肺癌试验组患者的IgG和C3输血后与输血前相比较差别有统计学意义(P<0.05),3组患者对照组输血前后免疫球蛋白以及补体的变化均差异无统计学意义(均P>0.05)。结论:部分慢性病患者机体免疫系统的变化可能是导致红细胞输注效果不佳的原因之一,对于这部分患者,应该综合考虑输血治疗方法的利弊后再慎重选择。

Objective：To study the relation between the levels of immunoglobulin G（IgG）,immunoglobulin A（IgA）,immunoglobulin M（IgM）and C3,C4 in the chronic disease patients and the effect of red blood cell（RBC）transfusion.Method：Patients with chronic aplastic anemia（CAA）,liver cancer and lung cancer were divided into test group and control group according to the effect of RBC transfusion.The serum level of IgG,IgA,IgM,C3 and C4 of all the patients were detected by enzyme immunoassay method before and after RBC transfusion.Result：There were 26 patients in test group and control group,respectively.The levels of serum IgG and IgA in CAA and liver cancer patients in test groups increased after five days transfusion（P〈0.05）.The levels of serum IgG and C3 in lung cancer patients in test group also increased after five days transfusion（P〈0.05）.The levels of serum immunoglobulins and complements of all the patients had no significant changes in the control groups（P〉0.05）.Conclusion：The changes of the immune system might be the one reason leading to ineffective RBC transfusion in some chronic disease patients.It would be more consideration and election when these patients need blood transfusion.