不同红细胞制剂输注对自身免疫性溶血性贫血患者输血疗效的影响

Therapeutic effects of infusion of different red blood cell products on patients with autoimmune hemolytic anemia

目的:探讨自身免疫性溶血性贫血(AIHA)患者输注不同红细胞制剂的疗效。方法:选取96例AIHA患者作为研究对象,依据输注红细胞制剂不同分为对照组(n=47,接受去白细胞悬浮红细胞输注)和观察组(n=49,接受洗涤红细胞输注)。比较两组患者的疗效、临床症状积分、血液指标及输注不良反应发生情况。结果:治疗后,观察组患者总有效率为93.88%,高于对照组的78.72%(P<0.05);观察组患者心悸、头晕、气短、乏力及胸闷症状评分分别为[(1.44±0.18)、(1.78±0.23)、(1.55±0.18)、(1.06±0.17)及(1.15±0.18)分],均低于对照组的[(1.92±0.23)、(2.04±0.25)、(1.74±0.21)、(1.43±0.18)及(1.24±0.17)分](P<0.05);观察组患者血红蛋白(Hb)、红细胞计数(RBC)水平分别为[(97.42±9.83)g/L、(4.72±0.48)×1012/L]高于对照组的[(80.54±8.35)g/L、(4.01±0.45)×1012/L](P<0.05),网织红细胞比例(Ret)、总胆红素(TBIL)为[(18.12±1.94)%、(26.33±2.75)μmol/L],低于对照组的[(21.33±2.56)%、(40.15±4.29)μmol/L](P<0.05)。两组患者输注不良反应总发生率无统计学差异(P>0.05)。结论:洗涤红细胞输注疗效更佳,可显著改善AIHA患者临床症状、血液指标,且安全性良好。

Objective:To investigate the therapeutic effects of infusion of different red blood cell products on patients with autoimmune hemolytic anemia(AIHA).Methods:A total of 96 patients with AIHA were selected,and divided into the control group(47 patients receiving infusion of leucodepleted red blood cell suspension)and the observation group(49 patients receiving infusion of washed red blood cells)according to the type of infused red blood cell product.Therapeutic effects,clinical symptom scores,blood indicators,and adverse reactions to infusion were compared between the two groups.Results:After treatment,the total effective rate in the observation group(93.88%)was higher than that in the control group(78.72%)(P<0.05).The scores for palpitation,dizziness,shortness of breath,fatigue,and chest tightness of the observation group[(1.44±0.18),(1.78±0.23),(1.55±0.18),(1.06±0.17)and(1.15±0.18)]were lower than those of the control group[(1.92±0.23),(2.04±0.25),(1.74±0.21),(1.43±0.18)and(1.24±0.17)](P<0.05).The levels of hemoglobin(Hb)and red blood cell count(RBC)in the observation group[(97.42±9.83)g/L and(4.72±0.48)×1012/L]were higher than those in the control group[(80.54±8.35)g/L and(4.01±0.45)×1012/L](P<0.05).The proportion of reticulocyte(Ret)and total bilirubin(TBIL)level in the observation group[(18.12±1.94)%and(26.33±2.75)μmol/L]were lower than those in the control group[(21.33±2.56)%and(40.15±4.29)μmol/L](P<0.05).There was no statistically significant difference in the total incidence of infusion adverse reactions between the two groups(P>0.05).Conclusion:Infusion of washed red blood cells has better efficacy.It can significantly improve clinical symptoms and blood indicators in patients with AIHA,with good safety.