性别因素在不同输血策略治疗中的影响  

Effects of sex factor on different transfusion strategies

作　　者：董春慧 代建昊 貌志成 杨立新 吴学忠 胡海 Dong Chunhui;Dai Jianhao;Mao Zhicheng;Yang Lixin;Wu Xuezhong;Hu Hai(Department of Laboratory Medicine,The First Affiliated Hospital of Anhui University of Science and Technology,Huainan 232007,Anhui Province,China)

机构地区：[1]安徽理工大学第一附属医院检验科,淮南232007

出　　处：《中国基层医药》2023年第7期1023-1027,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：蚌埠医学院自然科学重点项目(BYKY2019312ZD)。

摘　　要：目的对不同性别患者在输血后实验室指标进行收集与分析,评价输血效果,为制定更为科学的输血方案提供理论依据。方法回顾性分析安徽理工大学第一附属医院2020年1月至2021年12月输血患者808例的临床资料,根据输血策略和科室分为四组,外科限制性输血组(A组:男72例、女69例),外科非限制性输血组(B组:男77例、女118例),内科限制性输血组(C组:男184例、女126例),内科非限制性输血组(D组:男110例、女52例),进行单因素及多因素logistic回归分析。结果 A组输血后,女性的血红蛋白为79.0(71.5,87.0)g/L,高于男性的75.5(69.0,82.8)g/L,C反应蛋白为21.3(0.0,56.0)mg/L,低于男性的37.0(3.3,95.5)mg/L,差异均有统计学意义(Z=-2.18、-1.97,P=0.029、0.049)。B、C、D组输血后男性与女性血红蛋白、C反应蛋白、红细胞比容差异均无统计学意义(均P > 0.05)。多因素分析显示,A组输血前后血红蛋白差异有统计学意义(P=0.009),且女性输血后血红蛋白是男性的1.044倍。结论在外科限制性输血中,女性对失血的耐受程度高于男性,因此在输血时给予的女性血红蛋白的阈值可低于男性,在同等失血量情况下,可优先考虑男性输血,在血液资源匮乏的情况下,可适当降低女性输血的输注总量。Objective To collect and analyze laboratory indicators of patients of different sexes after blood transfusion,evaluate the effectiveness of blood transfusion,and provide a theoretical basis for formulating more scientific blood transfusion plans.Methods The clinical data of 808 patients who underwent blood transfusion in The First Affiliated Hospital of Anhui University of Science and Technology from January 2020 to December 2021 were retrospectively analyzed.According to the blood transfusion strategy and the department to which the patients were admitted,these patients were divided into four groups:surgical restrictive blood transfusion group(group A:72 males and 69 females),surgical non-restricted blood transfusion(group B:77 males and 118 females),medical restrictive blood transfusion(group C:184 males and 126 females),and medical non-restricted blood transfusion(group D:110 males and 52 females).Univariate and multivariate Logistic regression analyses were performed.Results In group A,after blood transfusion,hemoglobin level in female patients was significantly higher than that in male patients[79.0(71.5,87.0)g/L vs.75.5(69.0,82.8)g/L,Z=-2.18,P=0.029],and C-reactive protein in female patients was significantly lower than that in male patients[21.3(0.0,56.0)mg/L vs.37.0(3.3,95.5)mg/L,Z=-1.97,P=0.049].In groups B,C,and D,there were no significant differences in hemoglobin,C-reactive protein,and hematocrit between male and female patients(all P>0.05).Multivariate analysis showed that the difference in hemoglobin levels between before and after blood transfusion was statistically significant(P=0.009).After a blood transfusion,hemoglobin level in female patients was 1.44 times that in male patients.Conclusion The tolerance of female patients to blood loss is higher than that of male patients in surgical restrictive blood transfusion,so the threshold value of hemoglobin given to female patients during blood transfusion can be lower than that of male patients.In the case of the same blood loss,priority of blood tra

关 键 词：输血 性别因素 血红蛋白 C反应蛋白质 炎性反应 回顾性研究 

分 类 号：R457.1[医药卫生—治疗学]