滤除白细胞输血降低珠蛋白生成障碍性贫血患儿非溶血性发热性输血反应

Clinical Observation of Decreasing Febrile Non Hemolytic Transfusion Reaction by Infusion Erythrocyte after Filtering Leukocyte in Children with Thalassemia

目的了解滤白细胞红细胞（滤白）输注对降低重型β珠蛋白生成障碍性贫血（重型β地贫）患儿非溶血性发热性输血反应（FNHTR）的意义。方法2003年8月-2007年6月在本科输血治疗的重型β地贫患儿265例。男149例,女116例;患儿输血0.5-2.0单位/次。输血次数1-54次/人。悬浮红细胞（悬红）输注1992例次,共3114.5单位,滤白输注2416例次,共4354.5单位。滤白采用血站型滤白细胞红细胞器制作。悬红输注前根据体质量静泳注射2.5-5.0 mg地塞米松磷酸钠预防输血反应,滤白输注前不使用预防输血反应药物。应用SPSS 11.0软件进行统计学分析。结果悬红输注1 992例次中,发生FNHTR 49例次（2.460%）。滤白输注2 416例次中发生FNHTR 2例次（0.083%）。滤白输注FNHTR发生率显著低于悬红输注,差异有统计学意义（χ^2=53.95 P〈0.001）。结论输注滤白为重型β地贫患儿未来接受骨髓移植建立了安全的输血平台;重型β地贫患儿应输注滤白,以最大程度降低FNHTR发生率。

Objective To study the clinical significance of decreasing febrile non hemolytic transfusion reaction（FNHTR） by infusion erythrocyte after filtering leukocyte in children with β thalassemia major.Methods From Aug.2003 to Jun.2007,256 children with β thalassemia major received erythrocyte transfusion in our department,including 149 boys and 116 girls.Blood volume of transfusion 1 time was 0.5 unit at least and 2.0 units at most.Frequency of transfusion was 1 time at least and 54 times at most.One thousand nine hundred and ninety-two cases were received erythrocyte before filtering leukocyte 3 114.5 units together,2 416 cases were received erythrocyte after filtering leukocyte 4 354.5 units together.Erythrocyte were filtered by domestic leucocyte filter.Transfusion reaction was prevented before infusion erythrocyte before filtering leukocyte by injecting dexamethasone 2.5-5.0 mg according to weight.Before infusion erythrocyte after filtering leukocyte didn′t use any drug.SPSS 11.0 software was used to analyze the data.Results Forty-nine cases occurred FNHTR in 1 992 cases erythrocyter before filtering leukocyte,only 2 cases occurred FNHTR in 2 416 cases erythrocyter after filtering leukocyte.Obviously the incidence rate of erythrocyter after filtering leukocyte FNHTR was lower significantly than erythrocyter before filtering leukocyte（χ^2=53.95 P〈0.001）.Conclusions Transfusion erythrocyte after filtering leukocyte can make a safe transfusion platform for children with β thalassemia major to receive bone marrow transplantation in future.Children with β thalassemia major ought to transfusion erythrocyte after filtering leukocyte in order to decrease incidence rate of FNHTR.