不同输血方法治疗自身免疫性溶血性贫血疗效的Meta分析

THE EFFICACY OF DIFFERENT BLOOD TRANSFUSION METHODS IN THE TREATMENT OF AUTOIMMUNE HEMOLYTIC ANEMIA:A META ANALYSIS

目的应用Meta分析的方法分析不同输血方法治疗自身免疫性溶血性贫血(AIHA)的疗效。方法检索中英文检索数据库包括CNKI,万方,VIP,PubMed,MEDLINE,筛选含有悬浮红细胞、洗涤红细胞、洗涤红细胞输注联合血液置换治疗AIHA的相关文献。用NOS量表进行质量评价,RevMan5.0软件进行Meta分析,对于治疗自身免疫性溶血性贫血将悬浮红细胞输注作为A组,洗涤红细胞输注作为B组,洗涤红细胞输注联合血液置换治疗作为C组,首先对A、B二组的疗效进行Meta分析,然后合并A、B组与C组进行Meta分析,以OR和95%CI作为Meta分析的效应指标。必要时行异质性检验、敏感性分析,绘制森林图、绘制漏斗图。结果 A、B组Meta分析的结果:χ2=8.99(P=0.17,I2=33%),OR值与95%CI为0.79(0.49,1.28)。表明输注悬浮红细胞和输注洗涤红细胞治疗AIHA的效果没有差异,即差异无统计学意义。敏感性分析后,结果χ2=2.17(P=0.70,I2=0%),OR值与95%CI为0.99(0.57,1.72),差异无统计学意义。可以认为研究结果可信。合并A、B二组与C组Meta分析的结果:χ2=2.02(P=0.73,I2=0%),OR值与95%CI为0.08(0.03,0.23)。表明洗涤红细胞输注联合血液置换治疗AIHA优于输注悬浮红细胞和输注洗涤红细胞,差异有统计学意义。敏感性分析后,结果χ2=1.18(P=0.76,I2=0%),OR值与95%CI为0.07(0.02,0.22),差异有统计学意义。结果可信。结论输注悬浮红细胞和输注洗涤红细胞治疗AIHA的效果无差异,洗涤红细胞输注联合血液置换治疗AIHA优于输注悬浮红细胞和输注洗涤红细胞。

Objective To analyze the efficacy of different blood transfusion methods in the treatment of autoimmune hemolytic anemia by Meta analysis.Methods The retrieval of English database was performed including CNKI,Wanfang,VIP,PubMed,MEDLINE.The references were screened in related literature containing suspended red blood cells,red blood cell washing,washing red blood cell transfusion combined with blood replacement AIHA.Quality evaluation was carried out with the amount of NOS sheets.Revman5.0software was for Meta analysis.For the treatment of autoimmune hemolytic anemia with suspended red blood cell transfusion was as group A,washed red blood cell infusion was as group B,washed red blood cells lose injection combined with blood plasma replacement therapy was as group C.The first,we took a Meta analysis on curative effect group A and B,then merged the groups A,B and C were included in the meta-analysis,ORand 95% CI were as Meta analysis index of the effect.If necessary,heterogeneity test,sensitivity analysis would be used,Drew the forest mapping and funnel plot.Result The results of Meta analysis of group A and B：χ^2=8.99（P=0.17,I2=33%）,ORand 95%CI：0.79（0.49,1.28）.There was no difference in the effect of AIHA on the treatment of suspended red blood cells and washed red blood cells,that means,there was no statistically significant difference.after the sensitivity analysis.Results χ^2=2.17（P=0.70,I2=0%）,ORand 95%CI：0.99（0.57,1.72）,there was no statistically significant difference.It could be considered that the research results were credible.Merge the groups A,B and C for Meta analysis：χ^2=2.02（P=0.73,I2=0%）,ORand 95%CI：0.08（0.03,0.23）.The washed red blood cell transfusion combined with blood replacement was better than that of suspended red blood cell transfusion and washed red blood cell transfusion.There was statistically significant difference.After the sensitivity analysis,the results：χ^2=1.18（P=0.76,I2=0%）,ORand 95%CI：0.07（0.02,0.22）,there was statistically significant difference.It could be considered that the research results were credible.Conclusion There is no difference in the effect of AIHA on the treatment of suspended red blood cells and washed red blood cells.The washed red blood cell transfusion combined with blood replacement is better than that of suspended red blood cell transfusion and washed red blood cell transfusion.