糖皮质激素与洗涤红细胞输注联合治疗AIHA的疗效观察  

Glycocorticoids combined with infusion of washed red cells in treatment of autoimmune hemolytic anemia

作　　者：谢一唯[1] 李育[1] 陈秉宇[1] 

机构地区：[1]浙江省人民医院输血科,杭州310014

出　　处：《浙江医学》2016年第16期1348-1350,共3页Zhejiang Medical Journal

摘　　要：目的探究自身免疫性溶血性贫血(AIHA)患者的输血对策及其疗效和安全性。方法将206例AIHA患者根据治疗方案的不同分为A组和B组,各103例。A组患者予以糖皮质激素治疗,同时筛选ABO、Rh血型系统与患者相同的献血员进行交叉配血,采用反应强度最弱且凝集强度小于自身对照的红细胞悬液,制成洗涤红细胞进行输血治疗。B组患者仅予以糖皮质激素治疗。分析红细胞不相合输注治疗AIHA的疗效和安全性。结果 A组患者输血治疗后Hb水平明显高于输血治疗前(P<0.05)。A组与B组患者治疗前Hb水平比较无统计学差异(P>0.05);而治疗后,A组患者Hb水平高于B组患者(P<0.05)。A组患者均无溶血性输血反应发生。结论对于重度贫血的AIHA患者,采用糖皮质激素与最少不相合洗涤红细胞输注联合治疗能有效缓解贫血,是安全和有效的,值得在临床推广应用。Objective To evaluate the efficacy of combined glycocorticoids with infusion of washed red cells（WRC） in treatment of autoimmune hemolytic anemia（AIHA）. Methods Two hundred and six AIHA patients were randomly divided into group A and group B,with 103 cases in each group.Glucocorticoid treatment was given to all patients,in addition, patients in group A also received infusion of ABO and Rh cross- matched red blood cells with minimal reaction and less aggregation than the control. The efficacy and safety of treatment were evaluated and compared between two groups. Results After blood transfusion the hemoglobin level of patients in group A was increased, compared to that before treatment（P〈0.05）, and also higher than that in group B（P〈0.05）. There were no hemolytic transfusion reaction observed in group A. Patients with severe anemia exhibited a better transfusion benefit than those with mild and moderate anemia. Conclusion Combination of glycocorticoid therapy with infusion of washed red cells is safe and effective for patients with AIHA.

关 键 词：自身免疫性溶血性贫血 输血治疗 自身抗体 安全性 有效性 

分 类 号：R556.62[医药卫生—血液循环系统疾病]