严重贫血患者发生输血相关性急性肺损伤的影响因素分析  

Analysis of Influencing Factors the Occurrence of Transfusion-related Acute Lung Injury in Patients with Severe Anaemia

作　　者：田慧芳 TIAN Huifang(Ezhou Traditional Chinese Medicine Hospital,Hubei Province,Ezhou 436000,China)

机构地区：[1]湖北省鄂州市中医医院,湖北鄂州436000

出　　处：《中国医学创新》2023年第5期128-132,共5页Medical Innovation of China

摘　　要：目的:探讨严重贫血患者输血期间出现输血相关性急性肺损伤(TRALI)的影响因素。方法:回顾性分析2011年1月-2021年12月在鄂州市中医医院确诊为重度贫血且采取输血治疗的80例患者的临床资料,按是否发生TRALI进行分组,将患者分为TRALI组(n=26)与非TRALI组(n=54)。对比两组患者的一般资料、实验室检测指标与血制品相关指标,将具有组间差异的指标作为自变量,是否发生TRALI作为应变量,采用logistic回归分析法,探讨严重贫血患者输血治疗期间发生TRALI的影响因素。结果:单因素分析显示,两组总输液量、输血前休克、吸烟史、去白细胞红细胞悬液注射总量、去白细胞红细胞悬液存储时间、IL-6与TNF-α水平比较,差异均有统计学意义(P<0.05)。两组性别、年龄、围手术期输血量、HLA抗体Ⅰ、HLA抗体Ⅱ、白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、血肌酐(Scr)水平比较,差异均无统计学意义(P>0.05)。logistic回归分析显示,白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、去白细胞红细胞悬液注射总量是TRALI发生的危险因素(P<0.05)。结论:在严重贫血患者输血治疗期间,严重贫血患者输血治疗期间发生TRALI的影响因素主要有去白细胞红细胞悬液注射总量、IL-6、TNF-α,可将其作为输血治疗前评估TRALI风险的参考依据。Objective:To investigate the factors influencing of transfusion-related acute lung injury(TRALI)during blood transfusion therapy in patients with severe anemia.Method:The clinical data of 80 patients diagnosed with severe anemia and treated with blood transfusion therapy in Ezhou Traditional Chinese Medicine Hospital from January 2011 to December 2021 were retrospectively analyzed,they grouped according to whether TRALI occurred or not,and divided into TRALI group(n=26)and non-TRALI group(n=54).The general data,laboratory test indexes and blood product-related indexes of the two groups were compared,and the indexes with intergroup differences were used as independent variables and whether TRALI occurred as dependent variables,and logistic regression analysis was used to investigate the factors influencing the occurrence of TRALI during blood transfusion therapy in patients with severe anemia.Result:Univariate analysis showed that there were statistically significant differences in total infusion volume,pre-transfusion shock,smoking history,total injection amount of leukocytoxylated erythrocyte suspension,storage time of leukocytoxylated erythrocyte suspension,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels between the two groups(P<0.05).There were no significant differences in sex,age,perioperative blood transfusion,HLA antibody-Ⅰ,HLA antibody-Ⅱ,white blood cell count(WBC),hemoglobin(Hb),platelet count(PLT),serum creatinine(Scr)levels between the two groups(P>0.05).logistic regression analysis showed that the levels of IL-6,TNF-αand total injection amount of leukocytoxylated erythrocyte suspension were risk factors for the development of TRALI(P<0.05).Conclusion:During blood transfusion therapy in patients with severe anemia,the main influencing factors of TRALI occurrence in patients with severe anemia during blood transfusion therapy are the total injection amount of leukocytoxylated erythrocyte suspension,IL-6,and TNF-α,which can be used as a reference for assessing the risk of TRALI before bl

关 键 词：输血治疗 严重贫血 急性肺损伤 

分 类 号：R556[医药卫生—血液循环系统疾病] R457.1[医药卫生—内科学]