血液辐照预防输血相关性移植物抗宿主病的发生  

Prevention of transfusion-associated graft versus host disease by blood irradiation

作　　者：周丹[1] 

机构地区：[1]解放军总医院第一附属医院输血科,北京100048

出　　处：《中国医药导报》2012年第13期179-180,共2页China Medical Herald

摘　　要：目的探讨目前辐照血液的临床应用情况,比较在免疫功能低下人群输入照射及未照射血制品后输血相关移植物抗宿主病(TA-GVHD)发生率。方法采用回顾性分析方法,对2008年6月～2011年11月我院血液科收治住院的放化疗免疫功能低下患者400例进行临床观察,照射组200例病例中所有血制品均需经应用137csγ射线辐照处理,总剂量2 000 cGy,剂量率为200 cGy/min。另外200例患者使用的血制品未经辐射处理(未照射组),统计辐照rbcs的主要临床应用,观察高风险两组患者输血后ta-gvhd的发生率。结果未照射组200例免疫功能低下患者中,发现4例患有TA-GVHD,发生率为2.0%;照射组200例免疫功能低下患者中无一例发生TA-GVHD。结论137cs辐照红细胞,既能有效地抑制淋巴细胞活化增殖,其他细胞成分的损伤也较小。在免疫功能低下人群输注含淋巴细胞血制品时应去除和灭活淋巴细胞,照射可减少TA-GVHD的发生率。Objective To explore the clinical application of blood irradiation at present,and to compare the incidence of transfusion-associated graft versus host disease in patients with impaired immunity who was transfused blood which was ir radiated or not.Methods 400 patients with chemoradiation and low immune function were observed clinically in our hematology department from June 2008 to November 2011 by retrospective analysis.The blood products of 200 cases in ir radiation group were all needed irradiation of 137 cs gamma rays,total dose was 2000 cGy and dose rate achieved 200 cGy/min.Another blood of 200 patients was without radiation treatment.The main clinical application of RBCS irradiation was calculated.The incidence of ta-GVHD after blood transfusion was observed both in two high-risk groups.Results There were 4 TA-GVHD cases with 2.0% of the total in not irradiated group;thus there were no cases of TA-GVHD in ir radiated group.Conclusion It can not only suppress the activation and proliferation of the lymphocyte,but also reduce the damage of other cell components by 137 cs irradiation to red cell.Lymphocyte should be inactivated or reduced when blood is transfused to patients with impaired immunity,irradiation can reduce the incidence of TA-GVHD.

关 键 词：Γ射线 辐照 输血 移植物抗宿主病 发生率 

分 类 号：R457.7[医药卫生—治疗学]