单采自体红细胞患者发生不良反应的危险因素分析

Risk factors for adverse reactions in patients after apheresis technology for autologous red blood cells

目的 探讨单采自体红细胞患者发生不良反应的危险因素。方法 收集本院2019-2020年756例单采自体红细胞患者的临床资料。采用单因素分析单采自体红细胞患者发生不良反应的影响因素,Logistic回归分析单采自体红细胞患者发生不良反应的危险因素,广义估计方程分析多个时间点同一个患者血压和心率的差异。结果 纳入研究的756例患者中,有59例(7.8%)发生不良反应。其中以B类中的血管迷走神经反应(6.8%)、C类中的枸橼酸盐反应(93.2%)最常见。单因素分析结果显示:性别、年龄、BMI、全身血容量、治疗时长、采集前收缩压等影响因素具有统计学差异(P<0.05)。Logistic回归分析显示,年龄和血容量对单采自体红细胞不良反应的发生有影响(OR=0.954,95%置信区间:0.934~0.975;OR=0.356,95%置信区间:0.230~0.551,P<0.05)。结论 年龄偏小和血容量偏低是单采自体红细胞采集过程中发生不良反应的危险因素。

Objective To explore the risk factors for adverse reactions in patients undergoing apheresis for autologous red blood cells. Methods The clinical data of 756 patients for autologous red blood cells enriched by apheresis in our hospital from January 2019 to December 2020 were collected. Univariate analysis was used to study the influencing factors for adverse reactions in the process of apheresis. Logistic regression analysis was adopted to analyze the risk factors for adverse reactions in apheresis. The differences of blood pressure and heart rate of a same patient at multiple time points were analyzed by generalized estimation equation. Results Among the 756 patients, 59 of them(7.8%) had adverse reactions, including 6.8% vasovagal reaction in Class B and 93.2% citrate reaction in Class C. Univariate analysis showed that gender, age, BMI, body blood volume, treatment duration and systolic blood pressure before treatment had statistical significance(P<0.05). The results of logistic regression analysis showed that age and body blood volume had effects on adverse reactions in the process of apheresis(OR=0.954, 95%CI: 0.934~0.975;OR=0.356,95%CI: 0.230~0.551, P<0.05). Conclusion Younger age and lower blood volume are the risk factors for adverse reactions in the process of apheresis for autologous red blood cell collection.