去白细胞输血预防非溶血性发热性输血反应的临床应用分析(英文)

Clinical Assessment of Preventing Febrile Nonhemolytic Transfusion Reaction by Leukocyte-depleted Blood Transfusion

评价临床输注去白细胞的红细胞悬液和浓缩血小板悬液预防非溶血性发热性输血反应 (FNHTR)的效果。选择 1 0 0例肝硬化、胃溃疡和胃癌等病人输注去白细胞的红细胞悬液 ,对照组相类似 50例病人输注普通红细胞悬液。 2 4 0例急性或慢性白血病、再生障碍性贫血、多发性骨髓瘤、血小板减少性紫癜、糖尿病、肝硬化、上消化道出血、重症肝炎、烧伤、癌症放、化疗等患者分为两组 ,各组 1 2 0例随机接受去白细胞的血小板或未去白细胞的血小板悬液 ,观察FNHTR的发生率。结果表明 ,在 1 0 0例接受去白细胞的红细胞悬液的患者中未发生FNHTR ,对照组 50例患者中有 8例发生FNHTR ,发生率为 1 6 % ;输注血小板的患者中 ,去白细胞和未去白细胞的FNHTR发生7例和 2 5例 ,发生率分别为 5 .83 %和 2 0 .83 %。结论

The objective was designed to assess the clinical efficiency of preventing febrile nonhemolytic transfusion reactions (FNHTR) with transfusion of leukocyte depleted RBC and platelet concentrates. One hundred patients with cirrhosis of liver, gastric ulcer and cancer were selected to receive RBC concentrates with leukocyte filtration. Another gruop of 50 patients with liver necrosis, gastric ulcer and cancer were selected to receive non filtered RBC concentrates. Two hundred and forty patients with acute or chronic leukemia, aplastic anemia, multiple myeloma, thrombocytopenia purpura, diabetes mellitus, cirrhosis of liver, upper gastrointestinal hemorrhage, severe hepatitis, burn and cancer post radioactive or chemical treatment were divided into two group with 120 patients in each one and selected randomly to receive platelet concentrates. The incidence rates of FNHTR in all patients were investigated. Results showed that there was no FNHTR in 100 transfusions with leukocyte depleted RBC concentrates. Eight out of 50 patients with non filtrated RBC concentrates showed FNHTR. The incidence of FNHTR was sixteen (16%) in non filtrated transfusion. Twenty five and 7 patients manifested FNHTR respectively in non filtrated or filtrated platelets transfusions. The incidence of FNHTR was 20.83% and 5.83% respectively in non filtrated or filtrated platelet transfusion. It is concluded that leukocyte depleted RBC and platelet concentrates reduces FNHTR in blood transfusion.