洗涤红细胞和去白悬浮红细胞治疗自身免疫性溶血性贫血疗效和安全性的Meta分析  

Eficacy and safety of washed red blood cells and white suspended red blood cells in the treatment of autoimmune hemolytic anemia:a meta-analysis

作　　者：富文达 魏华 李丹 杨龙飞 FU Wenda;WEI Hua;LI Dan;YANG Longfei(Department of Blood Transfusion,the Second Affiliated Hospital of Air Force Medical University,Xi’an 710038,China)

机构地区：[1]空军军医大学第二附属医院输血科,陕西西安710038

出　　处：《中国输血杂志》2025年第2期284-290,296,共8页Chinese Journal of Blood Transfusion

基　　金：空军军医大学第二附属医院青年自主创新科学基金项目(2023BTDQN023)。

摘　　要：目的 系统性评价洗涤红细胞和去白悬浮红细胞对自身免疫性溶血性贫血患者的治疗效果,为其临床治疗提供参考依据。方法 检索知网、万方、维普、PubMed、Embase、Cochrane Library等数据库,检索时间从建库至2024年8月,纳入符合要求的洗涤红细胞和去白悬浮红细胞治疗自身免疫性溶血性贫血的随机对照试验,通过文献筛选、数据提取、质量评价后,采用Review manager 5.3软件和Stata 15.1软件对主要结局输血治疗效果、次要结局输血后2组的血液学指标(Hb、Ret、RBC和TBIL)和输血反应的发生情况进行Meta分析。结果 经过筛选,共检索出10篇文献符合本文标准,共计753名自身免疫性溶血性贫血的患者,观察组采用洗涤红细胞输注治疗,对照组采用去白悬浮红细胞输注治疗。Meta分析提示,输注洗涤红细胞与去白悬浮红细胞患者的输血治疗效果[SMD=1.16, 95%CI(0.87,1.54),P>0.05]无显著性差异,且输血后2组的血液学指标(Hb[SMD=0.04, 95%CI(-0.14,0.22),P>0.05]、Ret[SMD=-0.15, 95%CI(-0.34,0.03),P>0.05]、RBC[SMD=0.08, 95%CI(-0.10,0.26),P>0.05]和TBIL[SMD=-0.02, 95%CI(-0.18,0.15),P>0.05])以及输血反应的发生情况[SMD=0.8, 95%CI(0.47,1.39),P>0.05]无明显区别。结论 基于目前的研究,自身免疫性溶血性贫血的患者输注洗涤红细胞和去白悬浮红细胞疗效及安全性相当,但考虑到洗涤红细胞的制备过程简单且价格低廉,推荐自身免疫性溶血性贫血的患者输注洗涤红细胞。Objective To systematically evaluate the therapeutic effect of washed red blood cells and white suspended red blood cells on patients with autoimmune hemolytic anemia,and to provide reference for their clinical treatment.Methods CNKI,Wanfang,VIP,PubMed,Embase,Cochrane Library and other databases from the establishment of the database to August 2024 were searched,including the randomized controlled trials of washed red blood cells and white suspended red blood cells in the treatment of autoimmune hemolytic anemia that met the requirements.After literature screening,data extraction and quality evaluation,meta-analysis was performed using Review manager 5.3 software and Stata 15.1 software to analyze the therapeutic effect of blood transfusion in the primary outcome,hematological indicators(Hb,Ret,RBC,and TBIL)of the two groups after blood transfusion and the occurrence of adverse blood transfusion reactions.Results After screening,10 literatures meeting the criteria were retrieved,and a total of 753 patients with autoimmune hemolytic anemia were treated with washed red blood cell infusion in the observation group and white suspended red blood cell infusion in the control group.Meta-analysis suggested that there was no significant difference in the therapeutic effect of transfusion between patients who received washed red cells and those received white suspended red cells[SMD=1.16,95%CI(0.87,1.54),P>0.05].The hematological indexes of the two groups after transfusion(Hb[SMD=0.04,95%CI(-0.14,0.22),P>0.05]、Ret[SMD=-0.15,95%CI(-0.34,0.03),P>0.05]、RBC[SMD=0.08,95%CI(-0.10,0.26),P>0.05]and TBIL[SMD=-0.02,95%CI(-0.18,0.15),P>0.05])and the incidence of transfusion adverse reactions[SMD=0.8,95%CI(0.47,1.39),P>0.05]were not significantly different.Conclusion Based on the current study,the efficacy and safety of infusion of washed red blood cells and white suspended red blood cells are comparable in patients with autoimmune hemolytic anemia.However,considering the simple preparation process of washed red blood cells and th

关 键 词：洗涤红细胞 去白悬浮红细胞 自身免疫性溶血性贫血 META分析 

分 类 号：R457.1[医药卫生—治疗学]