血浆置换与去白细胞红细胞悬液输血在自身免疫性溶血性贫血中的应用  

Application of plasma exchange and leuko-reduced erythrocyte suspension transfusion in autoimmune hemolytic anemia

作　　者：王莹[1] WANG Ying(Department of Blood Transfusion,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学附属医院输血科,沈阳110032

出　　处：《临床与病理杂志》2021年第12期2889-2893,共5页Journal of Clinical and Pathological Research

摘　　要：目的:观察血浆置换与去白细胞红细胞悬液输血在温抗体型自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)患者中的应用价值。方法:选取辽宁中医药大学附属医院158例温抗体型AIHA患者,血浆置换与去白细胞红细胞悬液输血治疗100例(观察组),仅输血治疗58例(对照组),比较2组治疗前后相关补体(C3、C4)、抗双链-DNA(ds-DNA)滴度、血红蛋白(Hb)、网织红细胞(Ret)、红细胞计数(RBC)、血清总胆红素(TBIL)水平及不良反应情况。结果:观察组治疗后C3、C4、抗ds-DNA水平明显低于对照组(P<0.05);观察组治疗后Hb、RBC水平明显高于对照组(P<0.05),Ret水平明显低于对照组(P<0.05);AIHA患者血清Hb与RBC呈显著正相关(P<0.05),与Ret水平呈显著负相关(P<0.05);2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:血浆置换与去白细胞红细胞悬液输血治疗温抗体型AIHA,可更有效清除患者体内致病抗体和补体,提高血清Hb与RBC水平,降低Ret水平,且应用安全,具有重要应用价值。Objective:To observe the application value of plasma exchange and leuko-reduced erythrocyte suspension transfusion in autoimmune hemolytic anemia(AIHA) with warm-reactive antibodies.Methods:A total of 158 patients with AIHA with warm-reactive antibodies in our hospital were selected.Among them,there were 100 cases treated with plasma exchange and leuko-reduced erythrocyte suspension transfusion(the observation group),and 58 cases treated with blood transfusion only(the control group).Levels of related complements(C3,C4),anti-double-stranded DNA(ds-DNA) titer,hemoglobin(Hb),reticulocyte(Ret),red blood cell count(RBC) and serum total bilirubin(TBIL) before and after treatment,and adverse reactions were compared between the 2 groups.Results:After treatment,the levels of C3,C4,anti-ds-DNA,and Ret in the observation group were significantly lower than those in the control group(P<0.05),while the levels of Hb and RBC were significantly higher than those in the control group(P<0.05).Serum Hb was significantly positively correlated with RBC(P<0.05),and significantly negatively correlated with Ret in AIHA patients(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Plasma exchange and leuko-reduced erythrocyte suspension transfusion can effectively remove pathogenic antibodies and complements,increase their serum Hb and RBC levels and reduce Ret levels in patients with AIHA with warmreactive antibodies,with safety.And it is of important application value.

关 键 词：血浆置换 去白细胞红细胞悬液 自身免疫性溶血性贫血 病情 

分 类 号：R556.6[医药卫生—血液循环系统疾病]