血液置换和输入洗涤红细胞联合治疗对自身免疫性溶血性贫血患者血清铁蛋白、叶酸和维生素B12短期水平的影响

Effects of combined therapy of blood replacement and input washed red blood cells on short-term levels of serum ferritin,folic acid and vitamin B12 in patients with autoimmune hemolytic anemia

目的:探究自身免疫性溶血性贫血(AIHA)患者采用血液置换联合输入洗涤红细胞治疗后对血清中铁蛋白(SF)、叶酸(FA)和维生素B12(VB12)短期水平的影响。方法:按治疗方案不同将152例AIHA患者分为对照组(洗涤红细胞输注法)与研究组(洗涤红细胞输注法联合血液置换),每组各76例。记录两组患者治疗前、治疗后24 h血液营养成分、实验室指标、凝血功能指标水平,对比治疗后两组患者不良反应的发生差异。结果:治疗后24 h,两组患者网织红细胞、胆红素均低于治疗前,且研究组均低于对照组(P<0.05);RBC、Hb均高于治疗前,且研究组高于对照组(P<0.05)。研究组患者SF低于治疗前,且低于对照组(P<0.05)。两组患者输血后不良反应情况比较,差异无统计学意义(P>0.05)。结论:血液置换和输入洗涤红细胞联合治疗AIHA的短期临床疗效较高,可改善患者血液指标,且安全性较高。

Objective:To explore the effects of combined therapy of blood replacement and input washed red blood cells on short-term levels of serum ferritin(SF),folic acid(FA)and vitamin B12(VB12)in patients with autoimmune hemolytic anemia(AIHA).Methods:152 patients with AIHA were selected and divided into control group(infusion of washed red blood cells)and study group(infusion of washed red blood cells combined with blood replacement)according to different treatment schemes,with 76 cases in each group.The blood nutrient components,laboratory indicators and coagulation function indicators were recorded in the two groups of patients before treatment and at 24 h after treatment.The occurrence of adverse reactions after treatment were compared between the two groups.Results:24 h after treatment,the reticulocyte and bilirubin of the two groups were lower than those before treatment,and the above indicators of study group were lower than those of control group(P<0.05).The RBC and Hb were higher than those before treatment,and the two indicators were higher in study group than those in control group(P<0.05).The SF of patients in study group was lower than that before treatment,and lower than that in control group(P<0.05).The differences in adverse reactions after blood transfusion were not significant between the two groups of patients(P>0.05).Conclusion:Blood replacement combined with input washed red blood cells for the treatment of AIHA has the advantages of effectively enhancing the clinical efficacy and improving the blood parameters of patients in a short period of time,with good safety.