异丙嗪与地塞米松联合治疗输血不良反应临床研究

Clinical Study on Promethazine Combined with Dexamethasone in the Treatment of Adverse Transfusion Reactions

目的探讨异丙嗪与地塞米松联合注射治疗输血不良反应的临床疗效。方法选取医院2016年至2017年发生输血不良反应的患者124例,按随机数表法分为联合组与对照组,各62例。对照组患者给予地塞米松,联合组患者在此基础上肌肉注射异丙嗪。结果治疗后4 h时,两组患者生命体征[体温(BT)、心率(HR)]、血浆生化指标[嗜酸性粒细胞趋化因子(Eotaxin)、白三烯B4(LTB4)]、血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]水平均较治疗前有显著下降,两组患者血浆干扰素γ(IFN-γ)水平均较治疗前显著升高,且联合组明显优于同期对照组(P <0. 05)。联合组患者治疗总有效率为96. 77%,明显高于对照组的85. 48%(P <0. 05)。结论异丙嗪与地塞米松联合注射可有效改善输血不良反应患者的临床症状与体征,可显著降低其Eotaxin,LTB4,CRP水平,有利于输血及后续治疗措施有序开展。

Objective To investigate the clinical effect of promethazine combined with dexamethasone in the treatment of adverse transfusion reactions. Methods Totally 124 patients with adverse transfusion reactions in our hospital from 2016 to 2017 were selected and divided into the combined group and the control group according to the random number table method,62 cases in each group. The patients in the control group were treated with dexamethasone, on this basis, the patients in the combined group were treated with Promethazine for Injection. Results At 4 h after treatment,the levels of vital signs [ body temperature( BT),heart rate( HR) ],the levels of plasma biochemical markers [ eosinophil chemotactic factor( Eotaxin) and leukotriene B4( LTB4) ] and the levels of serum inflammatory factors [ C-reactive protein( CRP), tumor necrosis factor-α( TNF-α), procalcitonin( PCT) ] in the two groups were significantly lower than those before treatment, the levels of plasma interferon-γ( IFN-γ) in the two groups were significantly higher than those before treatment,and those in the combined group were significantly better than those in the control group( P < 0. 05). The total effective rate of the combined group was 96. 77%,which was significantly higher than 85. 48% of the control group( P < 0. 05). Conclusion The combined injection of promethazine and dexamethasone can effectively improve the clinical symptoms and signs of patients with adverse transfusion reactions, significantly reduce the levels of Eotaxin, LTB4 and CRP, which is conducive to the orderly development of blood transfusion and follow-up treatment.