血乳酸、白介素-8与慢性贫血患者成分输血治疗效果的关系  

Relationship Between Blood Lactic Acid,Interleukin-8 and the Therapeutic Effect of Component Transfusion in Patients with Anemia of Chronic Disease

作　　者：朱卫红 徐海燕 普玉景 李雪莹 ZHU Wei-hong;XU Hai-yan;PU Yu-jing;LI Xue-ying(Department of Blood Transfution,Zhoukou Orthopaedic Hospital,Zhoukou,Henan,466000,China)

机构地区：[1]周口骨科医院输血科,河南周口466000

出　　处：《中国血液流变学杂志》2023年第2期267-272,共6页Chinese Journal of Hemorheology

摘　　要：目的分析血乳酸(Lac)、白细胞介素-8(IL-8)与慢性贫血(ACD)患者成分输血治疗效果的关系。方法该研究为前瞻性研究,纳入周口骨科医院2018年10月—2021年10月收治的116例ACD患者作为研究对象,所有患者均符合输血指征,均在医院接受成分输血治疗,完成成分输血后观察1周,评估患者成分输血治疗效果,分为治疗无效组和治疗有效组。输血前,统计患者临床资料并检验相关实验室指标[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(HCT)、Lac、IL-8],分析各指标与ACD患者成分输血治疗效果的关系,重点检验Lac联合血清IL-8对ACD患者成分输血治疗无效的预测效能。结果收治的116例ACD患者,经成分输血治疗后,治疗有效88例,占75.86%;治疗无效28例,占24.14%。治疗无效组极重度患者占比高于治疗有效组,差异有统计学意义(P<0.05);两组其他资料比较,差异无统计学意义(P>0.05)。治疗无效组血浆Hb、RBC、HCT均低于治疗有效组,血清Lac、IL-8水平均高于治疗有效组,差异有统计学意义(P<0.05);两组TT、PT、APTT、FIB比较,差异无统计学意义(P>0.05)。经Logistics回归分析显示,血浆Hb、RBC低表达,血清Lac、IL-8高表达与ACD患者成分输血治疗无效有关(P<0.05)。绘制受试者工作特征曲线(ROC)显示,血清Lac、IL-8预测ACD患者成分输血治疗无效的曲线下面积(AUC)分别为0.790、0.808,均有一定预测效能。绘制决策曲线显示,在阈值0.2~0.4,0.8~1.0范围内,血清Lac、IL-8联合预测ACD患者成分输血治疗无效风险的的净获益率高于单一检测。结论血清Lac、IL-8高表达与ACD患者成分输血治疗无效有关,二者可作为预测ACD患者成分输血治疗效果的生物学指标。Objective To analyze the relationship between blood lactic acid(Lac),interleukin-8(IL-8)and the therapeutic effect of component transfusion in patients with anemia of chronic disease(ACD).Methods This study was a prospective study,including 116 patients with ACD admitted to Zhoukou Orthopaedic Hospital from October 2018 to October 2021.All patients met the indication of blood transfusion,all received component transfusion in the hospital.One week after completing component transfusion,the patients were divided into ineffective group and effective group.Before blood transfusion,the clinical data of patients were counted and relevant laboratory indexes were tested[thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),hemoglobin(Hb),red blood cell(RBC),hematocrit(HCT),Lac and IL-8],the relationship between each index and the therapeutic effect of component transfusion in patients with ACD was analyzed,the efficacy of Lac combined with serum IL-8 in predicting the ineffectiveness of component transfusion in patients with ACD was mainly tested.Results Among 116 patients with ACD,88 cases were effective after component blood transfusion,accounting for 75.86%.28 cases were ineffective,accounting for 24.14%.The proportion of extremely severe patients in the ineffective group was higher than that in the effective group,the difference was statistically significant(P<0.05).There was no statistical significant difference in other data between the two groups(P>0.05).The plasma Hb,RBC and HCT in the ineffective group were lower than those in the effective group,and the serum Lac and IL-8 levels were higher than those in the effective group,the differences were statistically significant(P<0.05).There was no statistical significant difference in TT,PT,APTT and FIB between the two groups(P>0.05).Logistic regression analysis showed that,the low expression of plasma Hb and RBC and the high expression of serum Lac and IL-8 were related to the ineffective treatment of component transfusion

关 键 词：慢性贫血 成分输血 血乳酸 白细胞介素-8 血红蛋白 红细胞 

分 类 号：R457.1[医药卫生—治疗学] R556[医药卫生—临床医学]