反复输注血液制品对血友病抗体及凝血因子活性的影响

Effectof Repeated Transfusion of Blood Products to Hemophilia Antibody and Coagulation

目的分析反复输注血液制品对血友病抗体及凝血因子活性的影响及临床意义。方法选取在某院反复接受血液制品(FⅧ制品或FⅨ制品)替代治疗的血友病患者45例为研究对象,记为研究组;同期选取初始输注FⅧ制品或FⅨ制品治疗的血友病患者40例为对照组,FⅧ活性(FⅧ:C)、Ⅸ活性(FⅨ:C)采取一期法检测,FⅧ抗体(FⅧ:Ab)、FⅪ抗体(FⅨ:Ab)采取Bethesda法检测。结果研究组HA 36例,FⅧ抗体滴度(3.41±1.72)Bu/ml,阳性率16.67%,Hb 9例,FⅨ滴度(2.67±1.53)Bu/ml,阳性率11.11%,抗体高、中、低分型依次为1例、4例和40例;对照组HA 32例,FⅧ抗体滴度(1.02±0.84)Bu/ml,阳性率6.25%,Hb 8例,FⅨ滴度(0.79±0.69)Bu/ml,阳性率0%;两组在FⅧ抗体滴度及总抗体阳性率、FⅧ抗体滴度对比差异上均显著(P<0.05)。结论反复输注FⅧ制品或FⅨ制品行血液替代,与血友病患者凝血因子抗体产生有直接的关系,这会降低凝血因子活性,不利于血友病的出血治疗。

Objective To analyze the effect of transfusion of blood products repeatedly to hemophilia antibody and coagulation factor＇ s activity and its clinical significance.Methods 45 patients with haemophilia who accepted blood products （F Ⅷ products or F Ⅸ products） repeatedly in a hospital of replacement therapy were selected as the observation group,while 40 patients with haemophilia who accepted blood products but not repeatedly were selected as the control group.Their FⅧ：C and F Ⅸ：C were by one stage method,as well as FⅧ：Ab and F Ⅸ：Ab by Bethesda assay.Results HA cases of the observation group were 36,and the F Ⅷ antibody titer was （3.41 ± 1.72） Bu/ml,the positive rate was 16.67 %,Hb cases were 9,the F Ⅸ titer was （2.67 ± 1.53） Bu/ml,the positive rate was 11.11%.antibody in high,low,type were 1 case,4 cases and 40 cases;HA cases of the control group were 32,and the F Ⅷ antibody titer was（1.02 ±0.84）Bu/ml,the positive rate was 6.25 %,Hb cases were 8,the F Ⅸ titer was （0.79 ± 0.69）Bu/ml,the positive rate was 0%.FⅧ antibody titer and the antibody positive rate,FⅧ antibody titer of the two groups showed significantly differences （P 〈 0.05）.Conclusion repeated infusions of F Ⅷ products or F Ⅸ products for blood substitute,patients with hemophilia factor antibody production has a direct relationship,this will reduce the activity of coagulation factors,so it is not conducive to the treatment of hemophilia hemorrhage.