骨髓增生异常综合征成分输血及部分输血反应分析  

Analysis of blood component transfusion and some adverse reactions in myelodysplastic syndroms patients

作　　者：徐文皓 赵佑山[2] 肖超[2] 常春康[2] XU Wenhao;ZHAO Youshan;XIAO Chao;CHANG Chunkang(Department of Blood Transfusion,Shanghai Sixth People′s Hospital affliated to Shanghai Jiaotong University School of Medicine,Shanghai 200233,China;Department of Hematology,Shanghai Sixth People′s Hospital affliated to Shanghai Jiaotong University School of Medicine,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院输血科,上海200233 [2]上海交通大学医学院附属第六人民医院血液科,上海200233

出　　处：《中国输血杂志》2023年第8期689-693,共5页Chinese Journal of Blood Transfusion

基　　金：上海市申康医院发展中心促进市级医院临床技能与临床创新三年行动计划关键支撑项目(SHDC2020CR6004)。

摘　　要：目的分析骨髓增生异常综合征(myelodysplastic syndroms,MDS)患者输血及输血反应以实现单病种输血管理持续改进。方法收集2003年1月—2022年12月本院MDS输血患者诊疗信息,包括成分输血(悬浮红细胞和/或单采血小板)及输血反应。结果799例MDS患者平均输注红细胞(27.46±43.11)单位,血小板(16.41±24.81)单位,输血量与性别和血型无关。输血反应发生率18.27%(146/799)。最常见的依次为迟发性血型血清学反应(delayed serologic transfusion reaction,DSTR)9.01%(72/799)、非溶血性发热反应4.76%(38/799)和过敏反应4.38%(35/799)。与全体入组输血患者相比,DSTR女性多见(P<0.05),年龄较大,RBC用量较高(P均<0.01);86.11%为Rh系统(62/72),40.28%含有≥2个抗体(29/72);部分患者DSTR产生时间与RBC输注量无关。结论MDS输血患者人均输血量高、输血反应尤其是DSTR风险较大。建议为MDS患者制定严格限制输血计划,并使用Rh表型匹配红细胞血液制品。探讨MDS患者不同时期的免疫状态有助于为DSTR发病机制提供新的研究方向和治疗措施并可适当调整抗体筛查时间。Objective To analyze the blood transfusion and adverse reactions in myelodysplastic syndroms(MDS)patients,so as to improve transfusion management in MDS patients.Methods The diagnosis and treatment information of MDS patients with blood transfusion in our hospital from January 2003 to December 2022 were collected,and the component transfusion and adverse reactions were investigated.Results The average infusion volume of red blood cells(RBCs)and platelets were respectively(27.46±43.11)and(16.41±24.81)in 799 MDS patients,which had no correlation with gender and blood type.The incidence of adverse reactions was 18.27%(146/799),with the most common adverse reactions as delayed serologic transfusion reaction(DSTR)(9.01%,72/799),followed by non hemolytic fever reaction(4.76%,38/799)and allergic reaction(4.38%,35/799).Compared with all patients with transfusion,DSTR was more common in females(P<0.05),with elder age and had more RBCs consumption(all P<0.01).86.11%(62/72)were Rh system,and 40.28%(29/72)had 2 or more antibodies.The occurrence time of DSTR in some patients was not related to the volume of RBCs trans infusion.Conclusion MDS patients,with more average transfusion volume and higher incidence of adverse reactions especially DSTR,were recommended a strictly limited transfusion schedule and Rh phenotype matching RBC products.The investigation of immune status of MDS patients at different periods is helpful to provide new aspects and therapeutic measures for the pathogenesis of DSTR,and the antibody screening time may adjusted appropriately.

关 键 词：骨髓增殖性肿瘤 成分输血 输血反应 迟发性血型血清学反应 

分 类 号：R457.1[医药卫生—治疗学] R551.3[医药卫生—临床医学]