不同输血方法在自身免疫性溶血性贫血患者中应用研究  

Effect of different blood transfusion methods on patients with autoimmune hemolytic anemia

作　　者：陆紫敏[1] 纪黎明[1] 梁萍[1] 祖亚钧[1] 孙向华[1] 

机构地区：[1]同济大学附属同济医院输血科,上海200065

出　　处：《中国输血杂志》2011年第9期750-752,共3页Chinese Journal of Blood Transfusion

摘　　要：目的观察应用不同输血方法在自身免疫性溶血性贫血患者中的临床疗效。方法将41名AIHA患者按不同输血方法分为3组:A组16例AIHA接受三洗红细胞输血;B组15例AIHA接受去白红细胞悬液输血;C组10例AIHA接受三洗红细胞输血联合血液置换治疗。所有入组患者均于输血前后进行血红蛋白、红细胞、网织红细胞、血清胆红素检测并进行比较。结果 1)各组输血后血红蛋白、红细胞均高于输血前,胆红素、网织红细胞均低于输血前(P<0.05);2)输血后:A组与C组的血红蛋白、红细胞、网织红细胞、胆红素指标比较有显著差异;3)A组与C组输血治疗总有效率比较差异有显著性,各组输血反应率比较均无显著差异。结论在AIHA患者中选择输血治疗时,不一定首选洗涤红细胞,选用去白悬浮红细胞也能达到同样的效果。选用联合血液置换的输血治疗对AIHA患者疗效更佳。Objective To evaluate the effect of different methods of blood transfusion on patients with autoimmune hemolytic anemia.Methods Forty one AIHA patients were divided into 3 groups,according to different methods of blood transfusion：Group A received transfusion of washed RBC,Group B received transfusion of leukocyte-reduced blood,and Group C received RBC transfusion combined with blood replacement.We tested the hemoglobin,RBC,reticulocytes,serum bilirubin of all patients in the three groups and compared their results.Results Hemoglobin and RBC after transfusion were higher than those before transfusion,whereas reticulocytes and serum bilirubin were lower than those before transfusion.Hemoglobin,RBC,reticulocytes,and serum bilirubin after transfusion were significantly different between group A and group B.The overall effectiveness of blood transfusion was different between groups A and C.The rates of transfusion reactions in each group showed no significant difference.Conclusion Washed RBC is not necessarily the first choice for AIHA patients.WBC depleted red blood cells could achieve the same effect.Blood exchange plus transfusion may be a better choice for AIHA patients.

关 键 词：贫血 输血 血液置换 

分 类 号：R457.1[医药卫生—治疗学] R556.6[医药卫生—临床医学]