洗涤红细胞联合血液置换治疗自身免疫性溶血性贫血对Hb和TBIL及FIB的影响

The effect of washing red blood cells combined with leukocytic suspending red blood cells to treat autoimmune hemolytic anemia on Hb,TBIL and FIB

目的探究自身免疫性溶血性贫血(AIHA)采用洗涤红细胞联合血液置换治疗对血红蛋白(Hb)、总胆红素(TBIL)、纤维蛋白原(FIB)影响。方法选择2018年6月-2022年6月北京积水潭医院贵州医院收治的AIHA患者124例作为研究对象,随机分为A组和B组,各62例,其中A组输注洗涤红细胞+血液置换,B组输注洗涤红细胞。观察两组治疗24 h后临床疗效及输血不良反应,统计前、后24 h血象[红细胞计数(RBC)、网织红细胞(Ret)、Hb、TBIL]、凝血功能指标[部分凝血活酶时间(APTT)、凝血酶原时间(PT)、FIB]。结果A组临床有效率96.77%高于B组87.10%,差异有统计学意义(χ^(2)=3.916,P=0.048)。A组和B组治疗后不良反应发生率均在10%以下,且差异无统计学意义(χ^(2)=0.435,P=0.510)。A组治疗后RBC、Hb高于B组(t=2.008、2.035,P=0.047、0.044),而Ret、TBIL低于B组(t=2.534、2.314,P=0.013、0.022),差异均有统计学意义。A组治疗后APTT、PT高于B组,FIB低于B组,差异均有统计学意义(t=3.732、2.137、2.064,P均<0.05)。结论AIHA患者选择洗涤红细胞联合血液置换治疗效果相对较好,不仅能改善患者血象,对其凝血功能改善效果也较好。

Objective To compare the effects of washing red blood cells combined with leukocytic suspension red blood cells on hemoglobin(Hb),total bilirubin(TBIL)and fibrinogen(FIB)in autoimmune hemolytic anemia(AIHA).Methods A total of 124 AIHA patients admitted to the Beijing Jishuitan Hospital and the Guizhou Hospital from June 2018 to June 2022 were selected as research objects and randomly divided into group A and group B with 62 cases in each group.Group A was transfused with scour red blood cells+leukocytic suspending red blood cells,and group B was transfused with scour red blood cells.Clinical efficacy and adverse blood transfusion reactions were observed 24 hours after treatment in the two groups.Red blood cell count(RBC),reticulocytes(Ret),Hb and TBIL in the blood before and after 24 hours were measured.Indicators of coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),FIB]were recorded.Results The clinical effective rate of group A was 96.77%,higher than that of group B(87.10%),the difference was statistically significant(χ^(2)=3.916,P=0.048).The incidence of adverse reactions in group A and group B after treatment was less than 10%,and there was no statistical significance(χ^(2)=0.435,P=0.510).After treatment,RBC and Hb in group A were higher than those in group B,the differences were statistically significant(t=2.008,2.035,P=0.047,0.044),while Ret and TBIL were lower than those in group B,the differences were statistically significant(t=2.534,2.314,P=0.013,0.022).After treatment,APTT,PT in group A were higher than those in group B,FIB in group A was lower than that in group B,the differences were statistically significant(t=3.732,2.137,2.064,all P<0.05).Conclusion The treatment effect of washing red blood cells combined with leukocytic suspension red blood cells in AIHA patients was relatively good,not only had a good improvement effect on the blood indexes of patients,but also had obvious improvement effect on the coagulation function of patients.