摘要
目的研究对直接抗人球蛋白试验(DAT)阳性的非自身免疫性溶血性贫血(AIHA)患者进行临床输血治疗的效果。方法选择2020年8月—2021年8月解放军陆军第七十三集团军医院收治的80例DAT阳性非AIHA患者作为研究对象,纳入研究组,将患者分为研究1组(40例,给予洗涤红细胞输注治疗)和研究2组(40例,给予普通红细胞悬液输注治疗);另外选择同期该院收治的40例DAT阴性非AIHA患者作为对照组,给予普通红细胞悬液输注治疗。分析DAT阳性非AIHA患者的疾病类型分布;观察并比较三组患者的输血效果检测指标,包括总胆红素(TBil)、直接胆红素(DBil)、血清白蛋白(ALB)、红细胞计数(RBC)、平均红细胞血红蛋白含量(MCH)以及血红蛋白(Hb)水平。结果80例DAT阳性非AIHA患者中重症监护病房(ICU)患者占比最高,为72.50%(58/80),其次为肿瘤患者,占16.25%(13/80),血液系统疾病、循环系统疾病、消化系统疾病、呼吸系统疾病患者占比分别为2.50%、3.75%、1.25%、3.75%。治疗前各组患者的TBil、DBil、ALB、RBC、MCH、Hb水平比较差异均无统计学意义。治疗后研究1组、研究2组、对照组的ALB、RBC、MCH、Hb水平比较差异仍无统计学意义[ALB(g/L):48.24±5.69、48.19±5.62、48.28±5.74,RBC(×10^(12)/L):2.28±0.43、2.29±0.46、2.26±0.42,MCH(pg):5.36±1.21、5.42±1.25、5.29±1.24,Hb(g/L):104.23±10.86、106.65±10.92、108.29±10.64,均P>0.05],但研究1组的TBil、DBil水平均明显高于研究2组和对照组[TBil(μmol/L):17.29±3.35比13.24±2.76、13.28±2.72,DBil(μmol/L):8.29±2.36比5.34±1.41、5.33±1.39,均P<0.05],研究2组与对照组TBil和DBil水平比较差异均无统计学意义(均P>0.05)。结论DAT阳性非AIHA患者使用洗涤红细胞输注治疗容易加重肝脏负担,而直接使用红细胞悬液输注安全性较高,治疗效果较好。
Objective To study the effectiveness of clinical blood transfusion treatment for non-autoimmune hemolytic anemia(AIHA)patients with direct antiglobulin test(DAT)positivity.Methods Totally 80 DAT positive non-AIHA patients admitted to the 73rd Group Military Hospital of PLA Ground Force from August 2020 to August 2021 were selected as research objects and included in research group.The patients were divided into research group 1(40 cases,treated with washed red blood cell infusion)and research group 2(40 cases,treated with ordinary red blood cell suspension infusion).In addition,40 DAT negative non-AIHA patients during the same period were selected as ontrol group and given conventional red blood cell suspension infusion treatment.The distribution of disease types in DAT positive non-AIHA patients was analyzed,the blood transfusion effect indicators of three groups of patients were observed and compared,including total bilirubin(TBil),direct bilirubin(DBil),albumin(ALB),red blood cell count(RBC),mean corpuscular hemoglobin content(MCH)and hemoglobin(Hb).Results Among the 80 DAT positive non-AIHA patients,intensive care unit(ICU)patients accounted for the highest proportion,accounting for 72.50%(58/80),followed by tumor patients,accounting for 16.25%(13/80),and patients with hematological,circulatory,digestive and respiratory diseases accounted for 2.50%,3.75%,1.25%and 3.75%,respectively.There was no statistically significant difference in the levels of TBil,DBil,ALB,RBC,MCH and Hb among the groups of patients before treatment.After treatment,there was no significant difference in the levels of ALB,RBC,MCH and Hb among research group 1,research group 2 and control group[ALB(g/L):48.24±5.69,48.19±5.62,48.28±5.74,RBC(×10^(12)/L):2.28±0.43,2.29±0.46,2.26±0.42,MCH(pg):5.36±1.21,5.42±1.25,5.29±1.24,Hb(g/L):104.23±10.86,106.65±10.92,108.29±10.64,all P>0.05].The levels of TBil and DBil in research group 1 were higher than those in research group 2 and control group[TBil(μmol/L):17.29±3.35 vs.13.24±2.76,13.28±2.72,DBil(μmol/L):8.29±2.36 vs.5.34±1.41,5.33±1.39,all P<0.05].There were no significant differences in TBil and DBil levels between research group 2 and control group(all P>0.05).Conclusion Non-AIHA patients with DAT positive may experience increased liver burden when treated with washed red blood cell infusion,while direct use of red blood cell suspension infusion is safer and has better therapeutic effects.
作者
叶晓芳
黄榕
张玲
Ye Xiaofang;Huang Rong;Zhang Ling(Department of Clinical Laboratory,the 73rd Group Military Hospital of PLA Ground Force,Xiamen 361000,Fujian,China)
出处
《实用检验医师杂志》
2023年第3期238-241,共4页
Chinese Journal of Clinical Pathologist
