临床输血不良反应研究及其危险因素的Logistic回归分析

Research on the adverse reactions of clinical blood transfusion and Logistic regression analysis of its risk factors

目的分析临床输血不良反应结构及其特点,探讨导致临床输血反应的危险因素。方法以2016年1月至2019年12月到佛山市三水区人民医院输血且发生输血不良反应患者87例为研究组,分析临床输血反应结构及其特点,随机选择同期到该院输血但未发生输血反应的90例患者为对照组,就两组对应因素进行统计学分析。结果87例输血不良反应结构为:过敏反应占比50.57%;非溶血性发热反应占比48.27%,输血后紫癜占比1.15%;输注成分以血浆/红细胞搭配输注、血浆、血小板、去白细胞悬浮红细胞分列前四位。研究组既往输血史、既往过敏史、IgE含量及不规则抗体阳性率均高于对照组,差异有统计学意义(P<0.05),两组在平均年龄、体重指数、文化程度、职业结构方面比较,差异无统计学意义(P>0.05);Logistic回归分析结果显示,既往输血史,既往过敏史、患者血液存在不规则抗体、免疫球蛋白IgE的过表达是临床输血不良反应的独立危险因素(P<0.05)。结论输血不良反应以过敏反应及非溶血性发热反应为主,搭配血浆/红细胞、单纯血浆输注及血小板输注是临床输血反应的主要构成;提高对免疫球蛋白IgE的高表达、反复多次输血、免疫性疾病史的患者输血过程的密切监控,或可减少输血不良反应的发生率。输血不良反应与患者自身年龄、体重、文化程度及职业结构无关。

Objective To analyze the structure and features of adverse reactions(ARs)of clinical blood transfusion,and to investigate the risk factors leading to clinical blood transfusion reactions.Methods In this research,patients who received blood transfusion in People's Hospital in Sanshui District of Foshan City from January 2016 to December 2019 were selected as the study group(n=87),and the structure and features of clinical blood transfusion reactions were analyzed.Other patients who received blood transfusion in the same period but did not have blood transfusion reactions were randomly selected as the control group(n=90).The corresponding factors of the two groups were statistically analyzed.Results The ARs structure of blood transfusion in 87 cases was the allergic reactions(accounting for 50.57%),the non-hemolytic fever(accounting for 48.27%)and purpura after blood transfusion(accounting for 1.15%).The top four transfusion components were combined transfusion of plasma/red blood cells,plasma,platelet and leukocytes-free suspended red blood cells.the blood transfusion history,allergy history and immunoglobulin E(IgE)content in the study group were all higher than those in the control group,with statistically significant differences(P<0.05).However,there were no statistically significant differences in the aspects of age structure,body mass index,education level and occupation structure between the two groups(P>0.05).Logistic regression analysis showed that the blood transfusion history,allergy history,irregular antibodies in the patient's blood and overexpressed immunoglobulin E(IgE)content were independent risk factors for the occurrence of ARs of clinical blood transfusion(P<0.05).Conclusion The main ARs of blood transfusion are allergic reactions and non-hemolytic fever reactions,and the main components of clinical blood transfusion reactions are the combined transfusion of plasma/red blood cells,simple plasma transfusion and platelet transfusion.The improvement of close monitoring of the blood transfusion process of patients with high expression of IgE,repeated blood transfusion and history of immune diseases may reduce the incidence of ARs of blood transfusion.ARs of blood transfusion are not related to patient themselves'age,weight,education level and occupational structure.