血浆置换联合洗涤红细胞输血治疗自身免疫性溶血性贫血的临床疗效及安全性研究  

Clinical efficacy and safety of plasmapheresis combined with washed red blood cell transfusion in the treatment of autoimmune haemolytic anaemia

作　　者：杨子怡[1] 闫慧[1] 刘鸿雁[1] 谢静静 Yang Ziyi;Yan Hui;Liu Hongyan;Xie Jingjing(Department of Blood Transfusion,Henan Provincial People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南省人民医院输血科,河南郑州450000

出　　处：《感染、炎症、修复》2025年第1期34-37,共4页Infection Inflammation Repair

摘　　要：目的:探讨血浆置换联合洗涤红细胞输血治疗自身免疫性溶血性贫血(AIHA)的临床疗效及安全性。方法:以河南省人民医院2022年4月至2024年5月收治的AIHA患者84例作为研究对象,将患者按病情轻重程度进行分级,再将各级别患者按随机数字表法分为对照组(洗涤红细胞输血治疗,n=41)与观察组(血浆置换联合洗涤红细胞输血治疗,n=43)。比较两组治疗疗效、血象指标[红细胞计数(RBC)、网织红细胞(Ret)、血红蛋白(Hb)、总胆红素(TBIL)]、凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]的变化以及不良反应发生情况。结果:相较于对照组(85.36%),观察组治疗总有效率(97.67%)更高(P<0.05);治疗后,两组RBC、Hb、FIB水平呈升高趋势,Ret、TBIL、APTT、PT水平呈降低趋势,且与对照组相比较,观察组RBC、Hb、FIB水平更高,Ret、TBIL、APTT、PT水平更低(P<0.05);两组不良反应发生率比较无统计学差异(P>0.05)。结论:与单纯洗涤红细胞输血治疗方法比较,联合血浆置换与洗涤红细胞输血治疗可有效提高AIHA患者临床疗效,改善凝血功能及血象指标,且具有较好的安全性。Objective:To investigate the clinical efficacy and safety of plasmapheresis combined with washed red blood cell transfusion in the treatment of autoimmune hemolytic anemia(AIHA).Methods:A retrospective analysis of 84 AIHA patients admitted to Henan Provincial People's Hospital from April 2022 to May 2024 was conducted as the study object.Firstly,AINA patients were stratified according to the severity of their disease,and then randomly numbered table method was used to determine the treatment methods for patients in each layer.They were divided into control group(washing red blood cell transfusion therapy,n=41)and observation group(blood replacement combined with washing red blood cell transfusion therapy,n=43).The treatment efficacy,haematological indexes[red blood cell(RBC)count,reticulocyte(Ret),hemoglobin(Hb),total bilirubin(TBIL)],coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)],and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group(85.36%),the total effective rate of the observation group(97.67%)was higher(P<0.05).After treatment,the RBC,Hb and FIB levels of the two groups showed an increasing trend,while the Ret,TBIL,APTT and PT levels showed a decreasing trend,and compared with the control group,the RBC,Hb and FIB levels in the observation group were higher,and the Ret,TBIL,APTT and PT levels were lower(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Compared with pure washing red blood cell transfusion therapy,combined plasma exchange and washing red blood cell transfusion therapy can effectively improve the clinical efficacy of AIHA patients,improve coagulation function and hematologic indicators,and it has better safety.

关 键 词：自身免疫性溶血性贫血 血浆置换 洗涤红细胞 输血 

分 类 号：R556.6[医药卫生—血液循环系统疾病]