摘要
目的了解自身免疫性溶血性贫血(AIHA)患者住院期间输血情况,评估不同血液制品输注疗效及安全性。方法回顾性分析2011-2014年入院的72名AIHA患者的血清学特征,按照接受交叉配血相合或者最小不相合的血制品、输注的血制品种类评估输注的疗效及输血不良反应情况。结果 72名患者中46名患者接受共计131次输血治疗,无1例发生输血不良反应,其中输血疗效可评估的89次,总有效率56.2%,部分有效率37.1%,无效率6.7%。按照交叉配血结果分为相合输注组与最小不相合输注组,其中相合输注组有效率54.5%,部分有效率41%,无效率4.5%,最小不相合输注组有效率56.7%,部分有效率35.8%,无效率7.5%,2组的疗效差异没有统计学意义。按输注的红细胞成分分为洗涤与非洗涤组,洗涤组有效率62.5%,部分有效率31.3%,无效率6.2%,非洗涤组有效率54.8%,部分有效率38.4%,无效率6.8%,2组的疗效差异没有统计学意义。结论 AIHA患者出现严重贫血症状,在临床药物起效前,应及时进行输血治疗。采用同型非洗涤红细胞或同型洗涤细胞输注都是相对安全的,不需等待洗涤红细胞悬液耽误抢救。另外,在无法鉴定同种抗体但需要紧急输血的情况下,输注最小不相合的血制品也是相对安全的。
Objective To analyze the transfusion efficiency of autoimmune hemolytic anemia patients（ AIHA） and to provide evidence for clinical blood transfusion. Methods The serological characteristics and the incidence of adverse transfusion reactions of 72 patients with idiopathic or secondary AIHA from 2011 to 2014 were analyzed retrospectively. The efficiency and safety of RBC transfusion were evaluated based on the different kinds of infused blood components and the compatibility of blood products. Results Forty six patients were transfused 131 times without any adverse transfusion reactions.There were 89 transfusions that can be analyzed. The total efficiency rate,total partial efficiency rate and total inefficiency rate were 56. 2%,37. 1% and 6. 7%,respectively. According to the results from the crossmatch,the patients were divided into either compatible group or minimal mismatched group. The efficiency rate,the partial efficiency rate and the inefficiency rate in compatible group was 54. 5%,41% and 4. 5%,respectively,while in the minimal mismatched group,the rates were 56. 7%,35. 8% and 7. 5%,respectively. There were no significant differences of transfusion efficacy（ P〉0. 05） in two groups. According to the different kinds of infused blood products,the patients were divided into washed RBC group and non-washed RBC group. The efficiency rate,partial efficiency rate and inefficiency rate in washed group（62. 5%,31. 3% and 6. 2%） were not significantly different from the nonwashed group（54. 8%,38. 4% and 6. 8%）. Conclusion Transfusion is efficient for the AIHA patients with severe anemia. Transfusion with the non-washed and washed RBC of the same ABO types is relatively safe for patients with severe anemia. Minimally mismatched blood product is comparatively safe when antibody cannot be identified in an emergency.
作者
王立新
陈春霞
魏曾珍
谭金哲
吴秋月
秦莉
WANG Lixin CHEN Chunxia WEI Zengzhen TAN Jinzhen WU Qiuyue QIN Li.(Department of Laboratory Medicine, West China Hospital, Sichuan University 610041, China.)
出处
《中国输血杂志》
CAS
北大核心
2017年第1期45-48,共4页
Chinese Journal of Blood Transfusion
关键词
自身免疫性溶血性贫血
输血
回顾分析
autoimmune hemolytic anemia
transfusion efficiency
retrospective analysis
作者简介
通信作者：秦莉（1963．01-），女，主任医师，主要从事血液疾病和t输血专业方面的研究，电话：028—85423510；Email：qinli7@126．com
