用白细胞滤器制备少白细胞血液的临床应用

The Preparation of White Blood Cell Depleted Blood by Using the WBC Filter

目的：探讨由白细胞滤器制备的少白细胞的红细胞对非溶血性发热性输血反应的预防作用。方法：临床选择３８例有多次输血史、近期连续发生两次及以上的非溶血性发热性输血反应的血液病患者，再次输血时，使用经白细胞滤器制备的少白细胞的红细胞制品，观察输血前、输血中、输血后的体温、脉搏、呼吸、血压、尿量、尿色等，并分别测定输血前后２４小时的血红蛋白含量，每次输血前抽血测定白细胞抗体、淋巴细胞毒试验及配合试验。结果：输注过滤法制备的少白细胞的红细胞制品发热反应率明显低于未去除白细胞的红细胞制品（ｐ＜０００１），２１例白细胞抗体阳性者，输注少白细胞的红细胞后发热反应率明显降低（ｐ＜００１）；１７例白细胞抗体阴性与２１例抗体阳性患者比较，输注少白细胞的红细胞发热反应率无明显差异（ｐ＞００５），输注少白细胞的红细胞后，血红蛋白平均升高１５７ｇ／Ｌ（范围１５～３０ｇ／Ｌ）。结论：白细胞滤器制备的少白细胞的红细胞制品能有效地预防白细胞抗体所致的同种免疫性非溶血性发热性输血反应，有临床实用价值。

Objective:To study the effectiveness of WBC filter produced by the Institute of Blood Transfusion,CAMS in preventing the non hemolytic fever reaction during blood transfusion.Method:38 patients with a history of multiple transfusions,two or more consecutive non hemolytic fever reactions during recent transfusions were selected.The patients were transfused with WBC depleted RBC produced by the WBC filter.Body temperature,pulse rate,respiration rate,blood pressure,and the quantity and color of urine were observed 30 minutes before transfusion,30,60,90 and 120 after the initiation of transfusion,30 and 60 minutes after the completion of transfusion.Hb were measured before and 24 hours after transfusion.Anti WBC antibody,lyphotoxin test and matching test were performed before each transfusion.Results:The incidence of non hemolytic fever reaction were significantly lowered when patients were given WBC filter treated blood (p<0 001).The patients Hb was increased by 15 7g/L (ranging form 15～30g/L) after receiving one unit of the treated blood.Conclusion:The WBC filter,by filtering out the WBC in the blood,can effectively prevent the anti WBC Ab induced,non hemolytic fever reaction in blood transfusion and can be recommended for clinical use.