C反应蛋白和嗜酸性粒细胞百分比在青年输血不良反应危险因素分析中的作用  

The Role of EO% and CRP in Risk Factors Analysis of Young Patients with Transfusion Related Adverse Reactions

作　　者：李楠 张怡宇 谢双锋[1] 黎燕玲 LI Nan;ZHANG Yi-yu;XIE Shuang-feng;LI Yan-ling(Department of Blood Transfusion,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510000,China;Clinical Laboratory,Shenzhen Pingle Orthopaedic Hospital,Shenzhen 518000,China)

机构地区：[1]中山大学孙逸仙纪念医院输血科,广东广州510000 [2]深圳平乐骨伤科医院检验科,广东深圳518000

出　　处：《中山大学学报（医学科学版）》2023年第2期335-341,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广州市科技计划项目(202102010314)。

摘　　要：[目的]探讨青年患者发生输血不良事件的危险因素及与外周血C反应蛋白(CRP)及嗜酸性粒细胞百分比(EO%)的关系。[方法]收集2019年1月-2020年12月发生输血不良反应的66例青年患者资料,做为观察组;对照组则随机选取未发生输血反应,且入院年月、科室、疾病、血制品类型、性别与观察组分别对应的66例青年患者。分析两组患者年龄、输血史、过敏史、输血前静脉血CRP及EO%水平,绘制受试者工作特征(ROC)曲线评价输血前静脉血CRP与EO%对输血不良反应预测的效能,并使用回归分析对危险因素进一步验证。[结果]与对照组患者相比,观察组发生非溶血性发热反应(FNHTR)患者输血前CRP更高;观察组发生过敏性输血反应(ATR)患者输血前CRP更高,有输血史者占比更高,输血前EO%更低,差异有统计学意义(P<0.05)。输入不同血液品种对发生ATR和FNHTR具有差异性(P<0.05)。输血前CRP对诊断FNHTR的ROC曲线下面积0.889,最佳截断值18.05 mg/L(P<0.05);输血前CRP对诊断ATR的ROC曲线下面积0.749,最佳截断值为17.6 mg/L(P<0.05)。[结论]输血前C反应蛋白水平是青年患者发生FNHTR和ATR的独立危险因素,对输血不良反应的发生具有诊断价值;EO%对输血不良反应的预测价值不足。[Objective]To discuss the correlation between young patients’adverse transfusion reaction and pre-trans⁃fusion C reactive protein(CRP)level and EO%(percentage of eosinophils).[Methods]The observation group was chosen from among sixty-six young patients who experienced transfusion-related adverse events between January 2019 and De⁃cember 2020.For each patient chosen to be included in the observation group,another patient from the same department,with the same disease and gender,who had been hospitalized in the same month and received the same type of blood prod⁃uct transfusion,but had not experienced any transfusion-related adverse effects,was chosen to be in the control group.We examined and compared their ages,transfusion experiences,allergy backgrounds,EO%,and CRP levels in peripheral blood prior to transfusion.A receiver operating characteristic(ROC)curve was used to examine the diagnostic value of EO% and CRP for transfusion-related adverse events. Simultaneously, a logistic analysis was performed on the risk factors for transfusion-related adverse events.[Results] Pre-transfusion CRP was higher in patients with FNHTR in the observa⁃ tion group than it was in patients in the control group;pre-transfusion CRP was also higher in patients with ATR in the ob⁃ servation group than it was in patients in the control group. There were also statistically significant differences between these variables in the percentage of patients with transfusion history and pre-transfusion EO% ( P<0.05). For the transfu⁃ sion of different blood types, there was statistical significance in the occurrence of ATR and FNHTR ( P<0.05). For the diagnosis of FNHTR, the CRP area under the ROC curve was 0.889, and the best cut-off value was 18.05 mg/L. For the di⁃ agnosis of ATR, the area under the ROC curve was 0.749, and the best cut-off values were 17.60 mg/L. [Conclusion] Pre transfusion C-reactive protein level is an independent risk factor for FNHTR and ATR in young patients;the predictive value of EO% for adverse blood

关 键 词：青年人 输血不良反应 嗜酸性粒细胞百分比 C反应蛋白 危险因素 

分 类 号：R457.1[医药卫生—治疗学]