自身免疫性溶血性贫血输血治疗方案回顾性分析

Retrospective analysis of blood transfusion therapy for autoimmune hemolytic anemia

目的探讨自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)患者输注去白细胞和.洗涤红细胞的实际效果,寻求安全有效的临床输血策略。方法选取2011年1月~2020年12月在我院进行输血治疗的71例AIHA患者,按输血类型分为A、B、C三组,A组(n=18)仅输注配血弱于自身去.白细胞红细胞悬液,B组(n=16)仅输注最小不配合洗涤红细胞,C组(n=37)随机输注两种细胞。对所有入组患者在输血前后进行输血疗效、配发血时间、输血前后血液指标、输血不良反应发生率比较。结果三组在输血疗效、输血前后血液指标、输血不良反应发生率方面的差异无统计学意义(P>0.05),在配发血时间上差异明显(P<0.05)。结论AIHA患者输注弱于自身去白细胞红细胞悬液和最小不配合洗涤红细胞应综合考虑各种因素,尤其是紧急抢救时,不必强求输注全配合洗涤红细胞。

Objective To investigate the effect of leukocyte-depleted red blood cells and washed red blood cells in patients with autoimmune hemolytic anemia(AIHA), and to seek a safe and effective clinical blood transfusion strategy. Methods A total of 71 patients with AIHA in the Fourth Affiliated Hospital of Harbin Medical University were divided into three groups according to the type of blood transfusion: group A only received leukocyte-depleted red blood cells matched weaker than their own, group B only received minimally matched incompatible washed red blood cells, and group C received both of red blood cells randomly. Blood transfusion efficacy, blood dispensing time, blood indexes and incidence of adverse reactions were compared before and after blood transfusion. Results There was no significant difference in blood transfusion efficacy, blood indexes before and after blood transfusion and incidence of adverse reactions among the three groups(P>0.05), but there was significant difference in blood dispensing time(P<0.05). Conclusion For AIHA patients, when the transfusion of leukocyte-depleted red blood cells is weaker than that of their own and the minimally matched incompatible washed red blood cells, various factors should be comprehensively considered, especially in emergency rescue, it is not necessary to infuse washed red blood cells with complete matched.