既往红细胞与血小板输注的交互作用对血液病患者红细胞输血无效的影响

Effect of interaction of past erythrocyte and platelet transfusion on ineffective RBC transfusion in patients with hematopathy

目的:探讨既往红细胞及血小板输注的交互作用与血液病患者红细胞输注无效的关系。方法:回顾性调查2017-08—2018-12接受输血治疗的血液病患者903例,其中男513例,女390例。采用多因素Logistic回归分析既往红细胞输注史、既往血小板输注史及二者的交互作用对血液病患者红细胞输血无效的影响。结果:①血液科903例患者红细胞输注无效率为28.6%(258/903)。②多因素Logistic回归分析结果显示:既往红细胞输注11~20袋(OR=3.112,95%CI 1.715~5.649)、既往红细胞输注≥20袋(OR=5.384,95%CI 3.011~9.627)与无效输血正相关。交互作用显示:既往红细胞输注11~20袋与既往血小板输注≥20袋(OR=4.790,95%CI 1.472~15.592)、既往红细胞输注≥20袋与既往血小板输注1~10袋(OR=2.731,95%CI 1.202~6.207)、既往红细胞输注≥20袋与既往血小板输注11~20袋(OR=2.459,95%CI 1.215~4.976)、既往红细胞输注≥20袋与既往血小板输注≥20袋(OR=3.307,95%CI 1.944~5.625)存在显著正交互作用。结论:既往红细胞输注史与血小板输注史存在正交互作用,二者的交互作用可能增加血液病患者红细胞无效输血发生风险,临床医生应予以重视。

Objective:To investigate the relationship between the interaction of past erythrocyte-platelet transfusion history and ineffective blood transfusion in patients with hematopathy.Method:Retrospective survey on 903 cases of patient with hematology who received blood transfusions in our hospital from August 2017 to December 2018.There were 513 males and 390 females.Multivariable logistic regression was used to analyze the factors associated with unsuccessful transfusion and the relationship between the interaction of past erythrocyte-platelet transfusion history and ineffective blood transfusion.Result:①Among the 903 cases,the probability of unsuccessful transfusion was 28.6%(258/903).②The results of multivariable logistic regression showed that previous RBC transfusion(11-20 bags)(OR=3.112,95%CI 1.715-5.649),more than 20 bags of previous RBC transfusion(OR=5.384,95%CI 3.011-9.627)were positively associated with unsuccessful transfusion.Interaction analysis showed that there were significant positive interaction between past red blood cell infusion(11-20 bags)and previous platelet infusion≥20 bags(OR=4.790,95%CI 1.472-15.592),past red blood cell infusion≥20 bags and past platelet transfusion(1-10 bags)(OR=2.731,95%CI 1.202-6.207),past red blood cell infusion≥20 bags and past platelet transfusion(11-20 bags)(OR=2.459,95%CI 1.215-4.976),past red blood cell infusion≥20 bags and past platelet transfusion≥20 bags(OR=3.307,95%CI 1.944-5.625).Conclusion:There is a positive interaction between previous history of red blood cell transfusion and platelet transfusion.The interaction effect which would increase the risk of unsuccessful transfusion in patients with hematopathy should be concerned by clinicians.