嗜酸性粒细胞与诱导期血液透析患者发生透析器首次使用综合征的相关性  

Correlation between eosinophils and first-use syndrome of dialyzer in hemodialysis patients during induction period

作　　者：王娟 宋利 全梓林 孙春艳 崔冬梅 赵立艳 钟咪 周丽芳 陈迎归 符霞 Wang Juan;Song Li;Quan Zilin;Sun Chunyan;Cui Dongmei;Zhao Liyan;Zhong Mi;Zhou Lifang;Chen Yinggui;Fu Xia(Blood Purification Center,Department of Nephrology,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510000,China;School of Nursing,Southern Medical University,Guangzhou 510515,China;Medical College,Shantou University,Shantou 515063,China)

机构地区：[1]广东省人民医院广东省医学科学院肾内科血液净化中心,广州510000 [2]南方医科大学护理学院,广州510515 [3]汕头大学医学院,515063

出　　处：《国际医药卫生导报》2021年第15期2367-2370,共4页International Medicine and Health Guidance News

摘　　要：目的探索嗜酸性粒细胞与诱导期血液透析患者发生透析器首次使用综合征(FUS)的相关性。方法回顾性收集2017年3月至2019年3月在广东省人民医院血液净化中心诱导期前3次透析治疗的临床资料。根据患者诱导期前3次治疗是否发生透析器FUS分为透析器过敏组和无透析器过敏组。观察透析器过敏组和无透析器过敏组嗜酸性粒细胞计数、白细胞计数、FUS发生率。结果共收集患者128例,患者年龄(54.8±13.9)岁,男性59例(46.1%)。与无透析器过敏组比较,透析器过敏组白细胞计数、嗜酸性粒细胞计数显著增高[(6.46±1.82)×10^(9)/L比(5.70±1.58)×10^(9)/L,t=-2.247,P=0.026;0.29(0.18~0.80)×10^(9)/L比0.26(0.13~0.31)×10^(9)/L,W=1550.5,P=0.045]。嗜酸性粒细胞计数≥0.55×10^(9)/L的患者有29例(22.66%),嗜酸性粒细胞计数<0.55×10^(9)/L的患者有99例(77.34%)。透析器过敏组FUS发生率为44.83%(13/29),无透析器过敏组19.19%(19/99)(χ^(2)=7.862,P=0.005)。结论嗜酸性粒细胞计数在发生FUS的患者中明显升高,对FUS的诊断具有较好的特异度,但敏感度较差。首次透析前嗜酸性粒细胞计数增高的患者,建议合理选用生物相容性好的透析器,并充分预冲,以降低FUS发生率。Objective To explore the correlation between eosinophils and the first-use syndrome(FUS)of dialyzer in hemodialysis patients.Methods The clinical data of the first 3 dialysis sessions during induction period at Blood Purification Center,Guangdong Provincial People's Hospital from March 2017 to March 2019 were retrospectively collected.The patients were divided into a dialyzer allergy and a no dialyzer allergy group according to whether the FUS of dialyzer occurred during the first three sessions during their induction period.The eosinophil counts,white blood cell counts,and incidences of FUS were compared between these two groups.Results One hundred and twenty-eight patients were collected,including 59 males(46.1%);and they were(54.8±13.9)years old.The white blood cell count and the eosinophil count in the dialyzer allergy group were significantly higher than those in the no dialyzer allergy group[(6.46±1.82)×10^(9)/L vs.(5.70±1.58)×10^(9)/L,t=-2.247,P=0.026;0.29(0.18-0.80)×10^(9)/L vs.0.26(0.13~0.31)×10^(9)/L,W=1550.5,P=0.045].There were 29 patients(22.66%)with the eosinophil count≥0.55×10^(9)/L and 99 patients(77.34%)with the eosinophil count<0.55 to 109/L.The incidence of FUS was 44.83%(13/29)in the dialyzer allergy group,and was 19.19%(19/99)in the no dialyzer allergy group(χ2=7.862,P=0.005).Conclusions Eosinophil count is significantly increased in patients with FUS.Eosinophil count has a good specificity but a poor sensitivity in the diagnosis of FUS.For patients with increased eosinophil count before their first dialysis,it is recommended to select a dialyzer with good biocompatibility and to fully pre-fill the dialyzer to reduce the incidence of FUS.

关 键 词：嗜酸性粒细胞 透析器 首次使用综合征 

分 类 号：R459.5[医药卫生—治疗学]