长期使用抗菌药物对恶性肿瘤患者红细胞输注疗效的影响

Effect of Long-term Use of Antibiotics on Red Blood Cell Transfusion in Patients with Malignant Tumors

目的:探讨长期使用抗菌药物对恶性肿瘤患者红细胞输注疗效的影响。方法:选择2019年3月—2021年3月河南第一大学附属医院就诊并接受红细胞输注治疗的恶性肿瘤患者为研究对象,选取其中输血前2周内曾接受至少3天以上的青霉素、头孢噻肟或阿莫西林输液抗感染治疗的89例患者作为研究组,选取输血前1个月内未曾接受抗菌药物治疗的恶性肿瘤患者89例作为对照组,评估两组患者红细胞输注效果并在输血前后对两组患者的血样行抗球蛋白试验(DAT)、抗菌药物抗体检验。结果:研究组输注红细胞有效率为74.56%,高于对照组的84.40%(P<0.05);研究组血样中青霉素、头孢噻肟和阿莫西林药物抗体检出率均高于对照组(P<0.05);研究组DAT试验阳性率高于对照组(P<0.05),且DAT试验阳性患者红细胞输注效果与非阳性患者相比明显较差(P<0.05)。结论:恶性肿瘤患者长期使用抗菌药物可能会影响其红细胞输注效果,其机制可能为抗菌药物诱导机体形成药物性抗体和红细胞致敏,对于此类长期使用抗菌药物的恶性肿瘤患者应慎重评估红细胞输注指征,避免无效输血。

Objective:To investigate the effect of long-term use of antibacterial drugs on the efficacy of red blood cell infusion in patients with malignant tumors.Methods:From March 2019 to March 2021,89 patients with malignant tumors who received red blood cell infusion therapy in the Affliated Hospital of Henan First University were selected as the study group,and 89 patients with malignant tumors who received penicillin,cefotaxime or amoxicillin infusion for at least 3 days within 2 weeks before blood transfusion were selected as the study group.89 patients with malignant tumors who did not receive antimicrobial therapy within 1 month before blood transfusion were selected as the control group.The effect of red blood cell infusion in the two groups was evaluated and the blood samples of the two groups were tested for antiglobulin test(DAT)and antimicrobial antibody before and after blood transfusion.Results:The effective rate of red blood cell transfusion in the study group was 74.56%,which was higher than 84.40%in the control group(P<0.05).The detection rates of penicillin,cefotaxime and amoxicillin drug antibodies in blood samples of the study group were higher than those of the control group(P<0.05).The positive rate of DAT test in the study group was higher than that in the control group(P<0.05),and the effect of red blood cell transfusion in patients with positive DAT test was significantly worse than that in non-positive patients(P<0.05).Conclusion:Long term use of antibacterial drugs in patients with malignant tumors may affect the effect of red blood cell transfusion.The mechanism may be that antibacterial drugs induce the body to form antibodies and sensitize red blood cells.For such patients with malignant tumors who hadbeen using antibacterial drugs for a long time,the indications for red blood cell transfusion should be carefully evaluated to avoid ineffective blood transfusion.