不同红细胞制品治疗原发性AIHA的回顾性分析

Comparison of different erythrocyte transfusion in primary AIHA patients

目的:探讨不同红细胞制品对原发性自身免疫性溶血性贫血(AIHA)疗效及不良反应发生率的影响。方法:对2014-05—2018-11实施红细胞输注治疗的136例原发性AIHA患者进行回顾性分析。根据输注红细胞制品的不同,分为A组76例(输注洗涤红细胞)和B组60例(输注去白红细胞)。观察2组临床疗效及治疗前后血红蛋白(Hb)水平、红细胞(RBC)数量、网织红细胞(Ret)所占比例、血清胆红素(TBIL)含量等。比较2组临床症状缓解情况,记录不良反应发生情况。结果:①A组治疗总有效率(78.9%)与B组(83.3%)比较差异无统计学意义(P>0.05)。②治疗前和治疗后A组Hb、RBC、Ret、TBIL与B组比较差异无统计学意义(P>0.05);2组治疗后与治疗前比较Hb、RBC明显增高(P<0.05),Ret、TBIL明显降低(P<0.05)。③治疗后A组与B组比较头晕、气短、乏力、心悸等临床症状完全缓解率及部分缓解率差异无统计学意义(P>0.05)。④2组不良反应发生率差异无统计学意义(P>0.05)。结论:输注洗涤红细胞及去白红细胞均可有效改善AIHA患者的临床指标,缓解其临床症状,在疗效及不良反应发生率方面接近。

Objective:To observe the curative effect and adverse events of different erythrocyte transfusion in treatment of primary autoimmune hemolytic anemia(AIHA).Method:The clinical data of 136 primary AIHA patients received erythrocyte transfusion in our hospital from May 2014 to November 2018 were reviewed retrospectively.All patients were divided into group A(infused with washed erythrocyte,n=76)and group B(infused with WBC-deplated erythrocyte,n=60).The clinical curative effect and hemoglobin(Hb)level,RBC number,ret ratio and serum bilirubin(TBIL)content before and after treatment were observed in two groups.The clinical symptom remission was compared between two groups.The adverse events were recorded in two groups.Result:①The total effective rate of group A(78.9%)and group B(83.3%)was not statistically significant(P>0.05).②There were no statistical differences in Hb,RBC,Ret and TBIL before and after treatment between the two groups(P>0.05).After treatment,there was a significant increase in Hb and RBC and a significant decrease in Ret and TBIL in the two groups(P<0.05).③There were no statistically significant differences in complete and partial remission rates of dizziness,shortness of breath,fatigue,palpitation and other clinical symptoms after treatment between the two groups(P>0.05).④There was no statistically significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion:Both washed erythrocyte and WBC-deplated erythrocyte could effectively improve the clinical indicators of AIHA patients and alleviate their clinical symptoms,which were similar in efficacy and incidence of adverse events.