基于倾向性评分匹配法冰冻解冻去甘油红细胞输注疗效与安全性评价  

Evaluation of the efficacy and safety of cryopreserved deglycerolized red blood cells infusion based on propensity score matching method

作　　者：杨薇 符帆帆 牛蕾 徐廷陈 张馨 师红梅 付丽辉 马春娅 于洋 YANG Wei;FU Fanfan;NIU Lei;XU Tingchen;ZHANG Xin;SHI Hongmei;FU lihui;MA Chunya;YU Yang(Department of Transfusion Medicine,First Medical Center,PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心输血医学科,北京100853

出　　处：《中国输血杂志》2025年第4期531-536,共6页Chinese Journal of Blood Transfusion

摘　　要：目的基于倾向性评分匹配法(propensity score matching,PSM)对比分析患者输注冰冻解冻去甘油红细胞(deglycerolized red blood cells,DRBC)与悬浮红细胞(suspended red blood cells,SRBC)的输注疗效及安全性,为临床合理利用冰冻红细胞资源提供依据。方法纳入2023年1月至2024年9月本院输注DRBC患者89例与输注SRBC患者2916例,采用1∶1最邻近PSM平衡性别、年龄、体质量指数(body mass index,BMI)等协变量。通过SPSS 26.0与R软件分析输血后72 h内最近1次血红蛋白(hemoglobin,Hb)、红细胞计数(red blood cell,RBC)、红细胞比容(hematocrit,HCT)及炎症指标如白细胞计数(white blood cell,WBC)、中性粒细胞(neutrophil,NE)、C-反应蛋白(C-reactive protein,CRP)及白细胞介素-6(Interleukin-6,IL-6)变化,以评估临床疗效及输注安全性。结果PSM后2组基线均衡(P>0.05)。DRBC组治疗总有效率(80.9%)与SRBC组(86.5%)无显著差异(P>0.05)。SRBC组患者WBC(×10~9/L)由9.634±6.742上升至10.147±6.835,CRP(mg/dL)由5.468±4.647上升至6.174±6.114,IL-6(pg/mL)由213.733±587.191下降至157.255±552.626;DRBC组患者WBC(×10~9/L)由11.123±7.880下降至11.011±8.549,CRP(mg/dL)由5.729±4.761下降至5.326±4.466,IL-6(pg/mL)由238.806±639.060下降至152.255±266.558,与治疗前相比,SRBC组与DRBC差异均无统计学意义(P>0.05)。在纳入统计的所有患者中,SRBC组输血反应总发生率为0.205%(6/2916),DRBC组未发生输血反应,SRBC组发生率高于DRBC。结论基于PSM分析DRBC输注疗效和安全性与SRBC无显著性差异,可为常态化应用提供循证支持。Objective To compare the efficacy and safety of deglycerolized red blood cells(DRBC)and suspended red blood cells(SRBC)based on the propensity score matching(PSM)method,so as to provide evidence for the rational use of DRBC resources in clinical practice.Methods A total of 89 patients who received DRBC transfusion and 2916 patients who received SRBC transfusion in our hospital from January 2023 to September 2024 were included.A 1∶1 nearest neighbor PSM was used to balance covariates such as gender,age,and body mass index(BMI).The changes of hemoglobin(Hb),red blood cell(RBC)count,hematocrit(HCT),and inflammatory markers such as white blood cell(WBC)count,neutrophil(NE)count,C-reactive protein(CRP),and Interleukin-6(IL-6)in the last 72 hours after transfusion were analyzed by SPSS 26.0 and R software to evaluate clinical efficacy and transfusion safety.Results The baseline of the two groups was balanced after PSM(P>0.05).There was no significant difference in the total effective rate between the DRBC group(80.9%)and the SRBC group(86.5%)(P>0.05).In the SRBC group,WBC(×109/L)increased from 9.634±6.742 to 10.147±6.835,CRP(mg/dL)increased from 5.468±4.647 to 6.174±6.114,and IL-6(pg/mL)decreased from 213.733±587.191 to 157.255±552.626.In the DRBC group,WBC(×109/L)decreased from 11.123±7.880 to 11.011±8.549,CRP(mg/dL)decreased from 5.729±4.761 to 5.326±4.466,and IL-6(pg/mL)decreased from 238.806±639.060 to 152.255±266.558.Compared with the before treatment,the differences between the SRBC group and DRBC group were not statistically significant(P>0.05).Among all patients included in the statistics,the overall incidence of transfusion adverse reactions was 0.205%(6/2916)in the SRBC group,and no adverse reactions occurred in the DRBC group.The incidence in the SRBC group was higher than that in the DRBC group.Conclusion Based on PSM analysis,there was no significant difference in the efficacy and safety of DRBC transfusion compared with SRBC transfusion,which can provide evidence-based support for routine

关 键 词：冰冻解冻去甘油红细胞 悬浮红细胞 输注疗效安全评价 倾向性评分匹配法 

分 类 号：R457.1[医药卫生—治疗学] R331.141[医药卫生—临床医学]