采用血栓弹力图监测指导血液制品输血对老年恶性肿瘤患者外周血T细胞亚群、凝血功能的影响  

Effects of blood product transfusion guided by thromboelastogram monitoring on peripheral blood T cell subsets and coagulation function in elderly patients with malignant tumors

作　　者：袁珊珊 高德玉 Yuan Shanshan;Gao Deyu(Department of Blood Transfusion;Clinical Laboratory,Hefei BOE Hospital,Hefei,Anhui,230012,P.R.China)

机构地区：[1]合肥京东方医院输血科,安徽合肥230012 [2]合肥京东方医院检验科,安徽合肥230012

出　　处：《老年医学与保健》2025年第1期57-60,68,共5页Geriatrics & Health Care

摘　　要：目的分析老年恶性肿瘤患者采用血栓弹力图监测(TEG)指导输血对外周血T细胞亚群、凝血功能的影响。方法前瞻性选择2021年2月—2024年11月合肥京东方医院收治的80例老年恶性肿瘤患者,根据指导输血方式不同将其分为研究组(n=40)和对照组(n=40)。研究组予以TEG指导输血,对照组则予以传统方法指导输血。观察并比较2组患者治疗前、后T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、凝血功能指标[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及纤维蛋白原(FIB)]、血栓弹力图指标[血凝块形成时间(K)、最大血凝块强度(MA)、综合凝血指数(CI)、凝血反应时间(R)、血凝块生成速率(Angle)]、输注血液情况。结果输血后,2组患者CD8^(+)值与同组输血前差异无统计学意义(P>0.05),而CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)值均低于同组输血前(P<0.05),研究组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)值均高于对照组(P<0.05);2组患者TT、APTT、PT值均小于同组输血前(P<0.05),FIB水平均高于同组输血前(P<0.05),研究组患者TT、APTT、PT值均小于对照组(P<0.05),而FIB水平高于对照组(P<0.05);研究组患者K、R值小于输血前(P<0.05),而MA、Angle、CI值升大于输血前(P<0.05)。结论TEG用于老年恶性肿瘤患者的输血指导中,可能改善患者凝血功能,而对细胞免疫功能的影响较小。Objective To analyze effects of blood product transfusion guided by thromboelastogram monitoring(TEG)on peripheral blood T cell subsets and coagulation function in elderly patients with malignant tumors.Methods A prospective study enrolled 80 elderly patients with malignant tumors admitted to Hefei BOE Hospital from February 2021 to November 2024.According to different methods of blood transfusion,they were divided into study group(n=40)and control group(n=40).The study group received TEG-guided blood transfusion,while the control group received traditional method-guided blood transfusion.T-cell subsets(CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)),blood coagulation function indicators[thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT)and fibrinogen(FIB)],TEG indicators[clot formation time(K),maximum clot strength(MA),comprehensive coagulation index(CI),coagulation reaction time(R)and clot generation rate(Angle)],and the condition of blood transfusion were observed and compared between the two groups before and after blood transfusion.Results After blood transfusion,CD8^(+)values showed no significant change in both group(P>0.05),while the values of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were all significantly lower than those in the same group before blood transfusion(P<0.05),and the values of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the study group were higher than those in the control group(P<0.05).The values of TT,APTT and PT in both groups were all significantly smaller than those in the same group before blood transfusion(P<0.05),and the FIB value was significantly larger than that in the same group before blood transfusion(P<0.05).The values of TT,APTT and PT in the study group were smaller than those in the control group(P<0.05),and the FIB value was larger than that in the control group(P<0.05).The values of K and R in the study group were significantly smaller than those in the same group before blood transfusion(P<0.05),while the values of MA,Angle and CI were significantly larger

关 键 词：老年 恶性肿瘤 血栓弹力图 输血治疗 凝血功能 细胞免疫功能 

分 类 号：R73[医药卫生—肿瘤]