洗涤红细胞输注与去白细胞悬浮红细胞用于AIHA的疗效及安全性

Effects and safety of transfusion of washed red blood cells and suspended leukocyte-depleted red blood cells in patients with AIHA

目的:分析输注洗涤红细胞及去白细胞悬浮红细胞用于自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)的疗效及安全性。方法:选取2021年1月至2022年12月保定市第一中心医院收治的96例AIHA患者为研究对象,依据治疗方式分为研究组(49例,输注洗涤红细胞)、对照组(47例,输注去白细胞悬浮红细胞),剂量均为0.1 U/kg,输注速度1~3 mL/kg,隔日1次,3次输注为1个疗程,均连续输注2个疗程。对比两组临床疗效、治疗前与治疗后各项临床症状积分、血液指标变化,记录输注不良反应情况。结果:治疗结束研究组的临床总有效率达93.88%,高于对照组的78.72%,差异有统计学意义;研究组治疗后头晕、气短、乏力等各项临床症状评分均低于对照组;治疗后研究组的血红蛋白(Hb)、红细胞计数(RBC)高于对照组,而网织红细胞比例(Ret)、总胆红素(TBIL)低于对照组;研究组与对照组的不良反应发生率分别为8.16%、6.38%,差异无统计学意义。结论:与去白细胞悬浮红细胞相比,洗涤红细胞可明显改善AIHA的临床症状、血液学与凝血功能指标,可进行推广。

Objective To analyze the effects of transfusion of washed red blood cells and suspended leukocyte-depleted red blood cells on patients with autoimmune hemolytic anemia(AIHA).Methods From January 2021 to December 2022,96 patients with AIHA were admitted to Baoding NO.1 Central Hospital.They were divided into the study group(49 patients washed with washed red blood cells)and the control group(47 patients washed with suspended leukocyte-depleted red blood cells)according to the treatment method.The doses in both groups were 0.1 U/kg,and the infusion rate was 1-3 mL/kg,once every other day.With 3 times of transfusion as a course of treatment,the patients were given 2 courses of treatment.Clinical effects and changes in clinical symptom scores and blood indicators before and after treatment were compared between the two groups.Adverse reactions to transfusion were recorded.Results After treatment,the clinical overall response rate in the study group reached 93.88%,which was significantly higher than 78.72%in the control group.After treatment,the study group had lower scores than the control group for clinical symptoms such as dizziness,shortness of breath,and fatigue.Compared to the control group,hemoglobin(Hb)and red blood cell count(RBC)in the study group were higher.The percentage of reticulocyte(Ret)and total bilirubin(TBIL)in the study group were lower.The incidences of adverse reactions in the study group and the control group were 8.16%and 6.38%,without significant difference between the groups.Conclusion Compared with transfusion of suspended leukocyte-depleted red blood cells,transfusion of washed red blood cells can significantly improve clinical symptoms,hematological and coagulation function indicators in patients with AIHA.