不同的红细胞制品输注治疗儿童重型地中海贫血的不良反应分析
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摘要
目的:探究不同的红细胞制品输注治疗儿童重型地中海贫血的不良反应。方法:选取笔者所在医院儿童重型地中海贫血96例,随机数字表法分为A组、B组、C组。A组给予普通红细胞输注,B组给予年轻红细胞输注,C组给予去白红细胞输注。对比三组不良反应发生情况及治疗前后检测三组T细胞亚群(T3、T4、T4/T8)、自然杀伤细胞(NK)细胞活性。结果:B组、C组FNHTR、输血性铁过载、免疫介导的输血不良反应发生率较A组低(P<0.05);治疗后B组、C组T3、T4、T4/T8、NK细胞活性较治疗前高(P<0.05);治疗后B组、C组T3、T4、T4/T8、NK细胞活性较A组高(P<0.05);输注后B组、C组Hb提升量高于A组(P<0.05)。结论:儿童重型地中海贫血采用年轻红细胞输注或去白红细胞输注治疗,可降低不良反应发生率,改善机体细胞免疫功能,提高输注效果。
Objective:To investigate the adverse reactions of different red blood cell products infusion for the treatment of severe thalassemia in children.Method:Ninety-six patients with severe thalassemia in our hospital were enrolled in this study.The random number table method was divided into group A,group B and group C.Group A was given a normal red blood cell transfusion,group B was given a red blood cell transfusion,and group C was given a white blood cell infusion.The activity of the three groups of T cells(T3,T4,T4/T8) and natural killer cells(NK) were compared before and after treatment.Result:The incidence of FNHTR,transfusion iron overload and immune-mediated transfusion adverse reactions in group B and C were lower than those in group A(P<0.05).The levels of T3,T4,T4/T8 and NK cell activities in group B and C after treatment were higher than those before treatment(P<0.05).The levels of T3,T4,T4/T8 and NK cells in group B and group C were higher than those in group A after treatment(P<0.05).After treatment,the increase of Hb in group B and group C was higher than that in group A(P<0.05).Conclusion:Children with thalassemia major are treated with young red blood cell transfusion or white blood cell infusion,which can reduce the incidence of adverse reactions and improve the cellular immune function,and improve the infusion effect.
Objective:To investigate the adverse reactions of different red blood cell products infusion for the treatment of severe thalassemia in children.Method:Ninety-six patients with severe thalassemia in our hospital were enrolled in this study.The random number table method was divided into group A,group B and group C.Group A was given a normal red blood cell transfusion,group B was given a red blood cell transfusion,and group C was given a white blood cell infusion.The activity of the three groups of T cells(T3,T4,T4/T8) and natural killer cells(NK) were compared before and after treatment.Result:The incidence of FNHTR,transfusion iron overload and immune-mediated transfusion adverse reactions in group B and C were lower than those in group A(P<0.05).The levels of T3,T4,T4/T8 and NK cell activities in group B and C after treatment were higher than those before treatment(P<0.05).The levels of T3,T4,T4/T8 and NK cells in group B and group C were higher than those in group A after treatment(P<0.05).After treatment,the increase of Hb in group B and group C was higher than that in group A(P<0.05).Conclusion:Children with thalassemia major are treated with young red blood cell transfusion or white blood cell infusion,which can reduce the incidence of adverse reactions and improve the cellular immune function,and improve the infusion effect.
引文
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[2]田茂兰.重型地中海贫血患儿家长社会支持与患儿遵医行为的相关性调查[J].护理研究,2012,26(8):701-702.
[3]梁志洪,王云秀,刘冬冬,等.广东地区地中海贫血基因携带者全血细胞计数结果分析[J].热带医学杂志,2014,14(7):846-849.
[4]伍昌林,王小华,何建安,等.长期输血的重型β地中海贫血患儿RH因子与临床输血有效性研究[J].中国实验血液学杂志,2015,23(6):1657-1661.
[5]刘兴玲,吴月勤,李惠森,等.123例重型β地中海贫血患儿输血治疗状况的调查[J].护理学报,2014,21(23):19-22.
[6]胡彩汀,叶龙英,艾妍贤,等.地贫儿童输注不同种类红细胞的疗效探讨[J].齐齐哈尔医学院学报,2015,36(21):3168-3169.
[7]杜伟,欧阳小峰,甘承文,等.重庆地区8024例地中海贫血筛查结果及地贫基因型分析[J].重庆医科大学学报,2014,38(5):694-697.
[8]郑琳,黄海龙,范向群,等.血细胞和血红蛋白分析在地中海贫血中的应用价值[J].中国妇幼保健,2016,31(3):547-549.
[9]王英,潘昆贻,黄际宪.红细胞与网织红细胞参数在缺铁性贫血与地中海贫血患儿中的意义[J].热带医学杂志,2014,14(10):1303-1305.
[10]何圆圆,汪德清,张新华,等.重型β地中海贫血患者输注不同库存时间红细胞后提升血红蛋白及2,3-二磷酸甘油酸的差异[C].//全国小儿血液病学术会议.2014.
[11]何圆圆,曾丽红,庄远,等.重型β地中海贫血患者输注保存不同时间红细胞后血红蛋白浓度的变化[J].中国输血杂志,2015,28(11):1351-1354.
[12]叶龙英,胡彩汀.不同的红细胞制品输注治疗儿童重型地中海贫血的不良反应[J].实用临床医学,2015,16(7):64.