大量输血对急诊外伤患者T淋巴细胞亚群、凝血功能和炎症因子水平的影响  

Effect of massive blood transfusion on T lymphocyte subsets, coagulation function and inflammatory factors in emergency trauma patients

作　　者：张荣[1] 任天红[1] 杨鑫 ZHANG Rong;REN Tianhong;YANG Xin(The Third Hospital of Shijiazhuang,Shijiazhuang,050001,China)

机构地区：[1]石家庄市第三医院,石家庄050001

出　　处：《临床血液学杂志》2022年第2期96-99,共4页Journal of Clinical Hematology

摘　　要：目的:研究大量输血对急诊外伤患者T淋巴细胞亚群、凝血功能和炎症因子水平的影响。方法:选择2018年5月—2021年1月收治的需输血的急性创伤患者92例,根据患者输血量分为A组(48例)和B组(44例),其中A组为需要大量输血治疗,B组为非大量输血治疗。比较2组患者治疗前后T淋巴细胞亚群、凝血功能和炎症因子水平变化,并观察血液指标情况。结果:A组患者红细胞、血浆、血小板以及冷沉淀的输注量均显著高于B组(P<0.05);2组患者治疗前、治疗后5 d T淋巴细胞亚群、凝血功能和炎症因子水平比较差异无统计学意义(P>0.05),治疗后1 d, 2组白介素-6、血红蛋白水平比较差异无统计学意义(P>0.05),但A组患者T淋巴细胞亚群水平、纤维蛋白原水平、血小板计数水平显著低于B组,凝血酶原时间、凝血酶时间、活化部分TT、肿瘤坏死因子-α、C反应蛋白水平显著高于B组,差异有统计学意义(P<0.05)。结论:大量输血虽可促进急诊创伤患者血容量的恢复,但输血可能会对机体凝血功能、免疫功能产生影响,并可能加重机体炎症反应。Objective: To study the effect of massive blood transfusion on T lymphocyte subsets, coagulation function and inflammatory factors in emergency trauma patients. Methods: Ninety-two emergency trauma patients who required blood transfusion in the hospital were selected as the research subjects between May 2018 and January 2021. According to blood transfusion volume, the patients were divided into group A(48 cases, massive blood transfusion) and group B(44 cases, non-massive blood transfusion). The changes in T lymphocyte subsets, coagulation function and inflammatory factors were compared between the two groups, and blood indexes were observed. Results: The infusion volume of erythrocytes, plasma, platelets, and cryoprecipitate in group A was significantly greater than those in group B(P<0.05). There were no statistically significant differences in T lymphocyte subsets, coagulation function, and inflammatory factor levels between the two groups before and at 5 d after treatment(P>0.05). 1 day after treatment, there were no significant differences in the levels of interleukin-6 and hemoglobin between the two groups(P>0.05), but the levels of T lymphocyte subsets, fibrinogen and platelet count in group A were significantly lower than those in group B, prothrombin time, thrombin time, activated partial TT, levels of tumor necrosis factor-α and C-reactive protein were significantly longer or higher than those in group B(P<0.05). Conclusion: Although massive blood transfusion can promote the recovery of blood volume in emergency trauma patients, coagulation function and immune function may be affected during transfusion, which may aggravate inflammatory response.

关 键 词：大量输血 急诊外伤 T淋巴细胞亚群 凝血功能 炎症因子 

分 类 号：R457.1[医药卫生—治疗学]