多种红细胞抗原相合性输血在自身免疫性溶血性贫血患者中的临床应用  

Clinical application of more red blood cell antigen compatible blood transfusion in patients with autoimmune hemolytic anemia

作　　者：张秋会 胡兴斌 安群星 孙文利 安宁 张婧 徐金梅 尹文 ZHANG Qiuhui;HU Xingbin;AN Qunxing;SUN Wenli;AN Ning;ZHANG Jing;XU Jinmei;YIN Wen(Department of Blood Transfusion,Xijing Hospital,the Fouth Military Medical University,Xi’an,710032,China)

机构地区：[1]空军军医大学西京医院输血科,西安710032

出　　处：《临床血液学杂志（输血与检验）》2020年第1期87-89,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:探讨多种红细胞抗原相合性输血在自身免疫性溶血性贫血(AIHA)患者中的临床应用效果,寻求安全有效的输血策略。方法:采用回顾性研究对196例AIHA患者的输血疗效进行统计与分析,其血清或放散液均经过同种或类同种抗体鉴定,红细胞进行直接抗人球蛋白试验检测。按照输注方式将其分为2组:试验组(相合性输注)和对照组(不合性输注),试验组选用:ABO、Rh、Kidd、Duff、MNSs、lewis血型系统抗原相合的主侧配血供者血液,对照组选用:ABO、Rh血型系统抗原相合的主侧配血供者血液,分别输注2单位后,观察2组患者输血前后血红蛋白(Hb)和血细胞比容(HCT)的变化情况及不良反应的发生。结果:试验组患者输血治疗后Hb和HCT水平明显高于输血治疗前(P<0.05)。试验组与对照组患者输血治疗前Hb和HCT水平差异无统计学意义(P>0.05);而输血治疗后,试验组患者Hb和HCT水平高于对照组患者(P<0.05)。试验组患者均无溶血性输血反应,输血有效性为100%。结论:对于AIHA患者的输血治疗,选用多种红细胞抗原相合性输血,能更好的提高临床输血的有效性和安全性,还能够有效的改善患者免疫状态和免疫反应,同时也减少了抗体的产生,保证了临床治疗效果。Objective:To explore the clinical effect of more erythrocyte antigen-compatible transfusion in the patients with autoimmune hemolytic anemia(AIHA),and provide laboratory basis for seeking safe and effective srategies for clinical transfusion therapy.Method:A retrospective study was conducted to analyze the blood transfusion effect of 196 AIHA patients.They were divided into two groups according to different transfusion methods:experimental group(compatible transfusion group)and control group(incompatible transfusion group).The compatible group was ABO,Rh,Kidd,Duff,MNSs,Lewis blood group compatible blood donors,and the incompatible group was ABO,Rh blood group compatible red blood cell antigen compatible main side matching blood plus self-pairing.The changes of hemoglobin(Hb)and hematocrit(HCT)before and after transfusion were observed in the two groups.Result:The levels of Hb and HCT in experimental group after transfusion were significantly higher than those before transfusion(P<0.05).There was no significant difference in the levels of Hb and HCT between the experimental group and the control group before transfusion(P>0.05).After transfusion,the levels of Hb and HCT in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:For AIHA patients,more erythrocyte antigen compatible transfusion can improve the efficacy and safety of clinical transfusion,improve the immune status and immune response of patients,and reduce the production of antibodies,thus ensuring the clinical efficacy of treatment.

关 键 词：自身免疫性溶血性贫血 多种血型抗原 相合性输血 输血疗效 

分 类 号：R556.6[医药卫生—血液循环系统疾病]