温抗体型自身免疫性溶血性贫血输血有效性分析  

Analysis of the effect of blood transfusion in patients with warm antibody type autoimmune hemolytic anemia

作　　者：赵震[1] 马筱慧[2] 钟靖 朱文刚 ZHAO Zhen;MA Xiaohui;ZHONG Jing;ZHU Wengang(Department of Blood Transfusion,the First Hospital of Jilin University,Changchun,130021,China;Department of Oncology,Cancer Center,the First Hospital of Jilin University;Department of Blood Transfusion,the Central Hospital of Shaoyang;Department ofBlood Transfusion,Fuyang People's Hospital,)

机构地区：[1]吉林大学第一医院输血科,长春130021 [2]吉林大学第一医院肿瘤中心肿瘤科,长春130021 [3]邵阳市中心医院输血科 [4]阜阳市人民医院(安徽医科大学附属阜阳人民医院)输血科

出　　处：《临床血液学杂志》2025年第2期109-112,共4页Journal of Clinical Hematology

基　　金：湖南省卫生健康委卫生科研课题资助(No:202211003190)。

摘　　要：目的:通过对温抗体型自身免疫性溶血性贫血(wAIHA)患者输血效果及安全进行分析,为此类患者临床输血提供依据。方法:回顾性分析2020年3月—2023年5月33例wAIHA患者,按是否输血分为输血组(19例)与未输血组(14例),比较两组患者出入院时血红蛋白(Hb)、总胆红素指标(TBIL)、白蛋白(ALB)及网织红细胞(Ret)的差异,比较不同时机贫血程度的输血前后Hb、总蛋白(TB)的差异。结果:33例患者中,输血全部有效;患者抗体类型,IgG 31例,IgG+IgM 1例,IgM 1例;直接抗人球蛋白阳性,IgG 11例,IgG+C3d 21例,C3d 1例;无输血不良反应;自身抗体32例(类抗-e 1例),自身抗体+同种抗体(抗-E)1例;输血组患者出院时Hb增加程度明显高于未输血组(P=0.007)、Ret降低程度明显高于未输血组(P=0.015),输血组与未输血组TBIL、ALB水平比较,差异无统计学意义;不同时机贫血程度的输血效果比较分析,Hb≤40 g/L组输血前后Hb[(35.50±3.02) g/L vs (51.13±4.87) g/L,P=0.003];40 g/L<Hb<50 g/L组输血前后Hb[(43.26±2.34) g/L vs (55.34±4.56) g/L,P=0.005];Hb≥50 g/L组输血前后Hb[(53.41±2.0) g/L vs (661.30±5.34) g/L,P<0.05],差异有统计学意义。Hb≤40 g/L组Hb增加最多ΔHb(15.53±4.78) g/L;Hb≥50 g/L组Hb增加最少ΔHb(9.56±3.76) g/L。结论:wAIHA患者可安全有效地输血,不可因不相容配血拒绝患者输血,输血可明显改善患者的临床症状。Objectives:To analyze the effect and safety of blood transfusion in patients with warm antibody type autoimmune hemolytic anemia(wAIHA),and provide a basis for clinical blood transfusion in such patients.Methods:Retrospective analysis of the differences was done in hemoglobin(Hb),total bilirubin index(TBIL),albumin(ALB)and reticulocytes(Ret)between the transfused and non-transfused groups at the time of admission and discharge in a total of 33 wAIHA patients from March 2020 to May 2023,and the differences between hemoglobin(Hb)and total protein(TB)before and after transfusion with different timing of the degree of anemia,the difference was statistically significant(P<0.05).Results:Of the 33 patients,14 in the non-transfused group and 19 in the transfused group,all transfusions were effective;regarding the types of antibodies in patients,they were a total of 31 cases of IgG,1 case of IgG+IgM,and 1 case of IgM;regarding direct antibody positivity,they were 1l cases of IgG,21 cases of IgG+C3d,and 1 case of C3d;no adverse reactions to blood transfusion;there were 32 cases of autoantibodies(1 case of class anti-e),and 1 case of autoantibodies+homologous antibodies(anti-E);patients in the transfusion group were discharged from the hospital with a significantly higher degree of increase in Hb than that in the non-transfusion group(P=0.oo7),a significantly higher degree of decrease in Ret than that in the non-transfusion group(P=0.O15),and the difference between TBIL and ALB,transfusion and non-transfu-sion groups was not statistically significant;comparative analysis of the effect of blood transfusion with different timing anemia degree,Hb before and after transfusion in Hb≤40 g/L group([35.50±3.02]g/L vs[51.13±4.87] g/L,P=0.003);Hb before and after transfusion in 40 g/L<Hb<50 g/L group([43.26±2.34]g/L vs[55.34±4.56]g/L.P=0.005);Hb before transfusion in Hb≥50 g/L group([53.41±2.0]g/L vs[661.30±5.34]g/L,P<0.05).Hemoglobin increased the most Hb(15.53±4.78)g/L in the Hb<40 g/L group;hemoglobin increased the leas

关 键 词：温抗体 自身免疫性溶血性贫血 输血 自身抗体 

分 类 号：R457[医药卫生—治疗学]