血浆置换与去白细胞红细胞输血对AIHA患者治疗效果的评价  

Therapeutic effects of plasma exchange and red blood cell transfusion following white blood cell filtration on patients with AIHA

作　　者：李红梅 夏姣 杨敏 LI Hongmei;XIA Jiao;YANG Min(Department of Laboratory Medicine,Guang’an People’s Hospital,Guang'an,638001,China)

机构地区：[1]四川省广安市人民医院检验科,四川广安638001

出　　处：《临床血液学杂志》2021年第8期579-582,共4页Journal of Clinical Hematology

摘　　要：目的:比较血浆置换与去白细胞红细胞悬液输血对自身免疫性溶血性贫血(AIHA)患者治疗效果。方法:选择2018年2月—2020年5月诊治的AIHA患者104例,随机分为置换组(50例)和输血组(54例),其中置换组给予血浆置换治疗,输血组给予去白细胞红细胞悬液输血治疗。比较2组患者治疗前后凝血功能:凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和凝血酶时间(TT);纤溶功能:纤溶酶原(Plg)、D-二聚体(D-D)、纤溶酶原激活物抑制物-1(PAI-1);不良反应:发热反应、过敏反应以及输血性紫癜。评估2组疗效和安全性。结果:2组患者治疗有效率比较差异无统计学意义(96.00%vs 88.89%,P>0.05);治疗前2组患者PT、APTT、TT、Plg、DD和PAI-1水平比较差异无统计学意义(P>0.05),治疗后输血组患者PT、APTT、TT和Plg水平均显著高于置换组,DD和PAI-1水平显著低于置换组(P<0.05);输血组发热反应、过敏反应以及输血性紫癜总发生率明显低于置换组(3.70%vs 16.00%,P<0.05)。结论:去白细胞红细胞悬液输血与血浆置换应用于AIHA患者治疗均具有较好的效果,但去白细胞红细胞悬液输血对于患者的凝血-纤溶功能改善效果更好,同时输血安全性更高。Objective:To compare the therapeutic effects of plasma exchange and red blood cell transfusion following white blood cell filtration on the patients with autoimmune hemolytic anemia(AIHA).Methods:A total of 104 patients with AIHA admitted to our hospital from February 2018 to May 2020 were enrolled and randomly divided into exchange group(50 cases,plasma exchange)and transfusion group(54 cases,red blood cell transfusion following white blood cell filtration).The coagulation function(prothrombin time[PT],activated partial thromboplastin time[APTT],thrombin time[TT])and fibrinolytic function(plasminogen[Plg],D-dime[DD],plasminogen activator inhibitor-1[PAI-1])before and after treatment,and adverse reactions(fever,allergic reactions and transfusion induced purpura)were compared between the two groups.The curative effect and safety in both groups were evaluated.Results:There was no significant difference in the response rate between the two groups(96.00%vs.88.89%,P>0.05).There were no significant differences in PT,APTT,TT,Plg,DD and PAI-1 levels between the two groups before treatment(P>0.05).After treatment,PT,APTT,TT and Plg levels in the transfusion group were significantly higher than those in the exchange group,while levels of DD and PAI-1 were significantly lower than those in the exchange group(P<0.05).The total incidence of fever,allergic reactions and transfusion induced purpura in the transfusion group was significantly lower than that in the exchange group(3.70%vs.16.00%,P<0.05).Conclusion:Both red blood cell transfusion following white blood cell filtration and plasma exchange may be effective in the treatment of AIHA patients.However,the former can better improve the patients’coagulation-fibrinolysis function,with higher safety.

关 键 词：血浆置换 去白细胞红细胞悬液输血 凝血功能 自身免疫性溶血性贫血 

分 类 号：R556[医药卫生—血液循环系统疾病]