Deparment of Rheumatology, Shizuoka Kousei Hospital, 23 Kitabanncho, Shizuoka, 420-8623, Japan,
Mod Rheumatol. 2004;14(1):77-81. doi: 10.1007/s10165-003-0271-4.
We gave preoperative blood transfusions to 37 patients with rheumatoid arthritis (RA) and 35 patients with osteoarthritis (OA), including some whose baseline hemoglobin level was less than 10 g/dl. Transfusion packs can preserve whole blood containing citrate phosphate dextrose (CPD) for 3 weeks. The baseline hemoglobin level of RA cases was 10.4 g/dl (range 8.4-13.1 g/dl), and that of OA cases was 11.9 g/dl (range 10.4-15.0 g/dl). By collecting 200-400 g every week before the operation, the total was 800-1200 g. Erythropoietin was given to patients intramuscularly when their hemoglobin was less than 13 g/dl after blood had been collected. Hemagglutination, with diameters of more than 1 cm, made filter occlusions in 11 RA cases (30%) and one OA case (3%) (P << 0.0031) after retransfusion. There were no differences between hemagglutination patients (agglutination group) and nonhemagglutination patients (nonagglutination group) regarding baseline C-reactive protein (CRP), white blood cells, platelets, or fibrinogen. We could not predict the formation of macrohemagglutination in the packs collected during the clinical course. In RA cases, allogenic transfusions were performed for four cases (36%) in the agglutination group and for one case (12%) in the nonagglutination group. Preoperative transfusion for the RA patients showed hemagglutination in some cases, and highlighted the need for modifications to reduce these hemagglutinations.
我们给 37 例类风湿关节炎（RA）患者和 35 例骨关节炎（OA）患者输注了术前血，其中一些患者的基础血红蛋白水平低于 10 g/dl。输血袋可以保存含有柠檬酸钠磷酸盐葡萄糖（CPD）的全血 3 周。RA 组的基础血红蛋白水平为 10.4 g/dl（范围 8.4-13.1 g/dl），OA 组为 11.9 g/dl（范围 10.4-15.0 g/dl）。通过在手术前每周采集 200-400 g，可以采集 800-1200 g。在采血后血红蛋白低于 13 g/dl 时，给患者肌肉内注射促红细胞生成素。在重新输血后，11 例 RA 患者（30%）和 1 例 OA 患者（3%）（P << 0.0031）出现直径超过 1 cm 的红细胞凝集，导致过滤器堵塞。在凝集患者（凝集组）和非凝集患者（非凝集组）之间，基础 C 反应蛋白（CRP）、白细胞、血小板或纤维蛋白原没有差异。我们无法预测在临床过程中采集的血袋中是否会形成巨凝集。在 RA 患者中，凝集组中有 4 例（36%）和非凝集组中有 1 例（12%）进行了同种异体输血。RA 患者的术前输血在一些情况下出现了凝集，这突出表明需要进行修改以减少这些凝集。
