血清Eotaxin、PAF与急性大出血输血相关性急性肺损伤患者预后的关系分析  

Analysis on relationship between serum Eotaxin and PAF with prognosis in patientswith acute massive hemorrhage transfusion related acute lung injury

作　　者：王凌雪 蔡娜 WANG Lingxue;CAI Na(Department of Blood Transfusion,Xi′an Municipal Chang′an Hospital,Xi′an,Shaanxi 710199,China)

机构地区：[1]陕西省西安市长安医院输血科,陕西西安710199

出　　处：《检验医学与临床》2023年第24期3638-3641,3647,共5页Laboratory Medicine and Clinic

基　　金：陕西省西安市第六批科技计划项目(20220384)。

摘　　要：目的 研究血清嗜酸性粒细胞趋化因子(Eotaxin)、血小板活化因子(PAF)与急性大出血输血相关性急性肺损伤(TRALI)患者预后的关系。方法 回顾性选取该院2019年1月至2022年10月收治的144例TRALI患者(急性大出血患者输血后发生)作为观察组,另选同期未发生TRALI的急性大出血患者140例作为对照组。根据观察组10 d预后情况,将其分为存活组与死亡组。比较各组血清Eotaxin及PAF水平,采用多因素Logistic回归分析TRALI患者死亡的危险因素,采用受试者工作特征(ROC)曲线分析血清Eotaxin及PAF水平对TRALI患者死亡风险的预测价值。结果 观察组血清Eotaxin及PAF水平均高于对照组(P<0.05)。死亡组血清Eotaxin及PAF水平均高于存活组(P<0.05)。存活组和死亡组患者在不同输血次数、不同发血至输血间隔、既往有输血史及过敏史中的比例差异均有统计学意义(P<0.05)。多因素Logistic回归分析发现,输血次数>2次、发血至输血间隔≥0.5 h、既往有输血史、有过敏史、Eotaxin水平升高及PAF水平升高均是TRALI患者死亡的危险因素(P<0.05)。ROC曲线显示血清Eotaxin及PAF水平联合检测对TRALI患者死亡风险的预测价值最高,曲线下面积(AUC)达到0.893(95%CI:0.846~0.916)。结论 血清Eotaxin及PAF与TRALI患者的预后有关,临床检测血清Eotaxin及PAF水平有助于更好地评价患者的预后。Objective To study the relationship between serum eosinophil chemotactic factor(Eotaxin)and platelet activating factor(PAF)with the prognosis of transfusion related acute lung injury(TRALI)in the patients with acute massive hemorrhage.Methods A total of 144 patients with TRALI(occurrence after blood transfusion in the patients with massive hemorrhage)were retrospectively selected from this hospital from January 2019 to October 2022 as the observation group,and other 140 patients with acute massive bleeding without causing TRALI during the same period served as the control group.Based on the 10 d prognosis situation in the observation group,they were divide into the survival group and death group.The serum Eotaxin and PAF levels were compared among the groups.The multivariate Logistic regression was adopted to analyze and observe the risk factors for the death risk in the patients with TRALI.The receiver operating characteristic(ROC)curve was adopted to analyze the predictive value of serum Eotaxin and PAF for the dearth risk of the patients with TRALI.Results The serum Eotaxin and PAF levels of the observation group were higher than those of the control group(P<0.05).The serum Eotaxin and PAF levels of the death group were significantly higher than those of the survival group(P<0.05).The proportions in different blood transfusion times,different intervals from sending blood to transfusion,previous blood transfusion history and allergy history had statistical differences between the survival group and the death group(P<0.05).The multivariate Logistic regression analysis found that the transfusion frequency>2 times,interval from sending blood to transfusion≥0.5 h,past blood transfusion history,allergy history,Eotaxin level increase and PAF level increase all were the risk factors for the death in the patients with TRALI(P<0.05).The ROC curve showed that the combination detection of serum Eotaxin and PAF levels had the highest predictive value for the death risk,and the area under the curve(AUC)reached 0.893(95%CI

关 键 词：嗜酸性粒细胞趋化因子 血小板活化因子 输血相关性急性肺损伤 预后 

分 类 号：R457.1[医药卫生—治疗学] R563[医药卫生—临床医学]