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[40例自身免疫性溶血性贫血患者输血及激素治疗的疗效与安全性评估]

[Evaluation of Efficacy and Safety of Blood Transfusion and Hormone Therapy in 40 Patients with Autoimmune Hemolytic Anemia].

作者信息

Yang Nan, Wang Bei, Gao Feng, Huang Xiao-Yan, Zhao Xiao-Li, Wang Yi-Yuan, Zhang Xiao-Ping

机构信息

Department of Blood Transfusion, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu Province, China.

Lanzhou No. 4 Middle School, Lanzhou 730050, Gansu Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Aug;28(4):1307-1311. doi: 10.19746/j.cnki.issn.1009-2137.2020.04.038.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of different types of red blood cell (RBC) transfusion and hormone therapy in patients with autoimmune hemolytic anemia (AIHA).

METHODS

The clinical data and serological characteristics of 40 patients with AIHA treated in our hospital from 2014 to 2018 were collected and analyzed retrospectively. The efficacy and safety of different type of RBC transfusion and hormone therapy were evaluated according to the principle of minimally incompatible RBC transfusion after cross-matching.

RESULTS

Among 40 patients with AIHA, the female cases were more than the male cases, the cases of secondary AIHA was more than cases of primary AIHA, and the warm autoantibodies were in the majority. 11 cases of AIHA underwent 26 times minimally incompatible red blood cell transfusions. The total effective rate was 46.2%, the partial efficiency was 23.1%, and total inefficiency was 30.8%. Among them, the same type of non-washing red blood cell group showed efficiency of 42.1%, partial effective rate of 21.1%, and inefficiency of 36.8%; the same type of washed red blood cell group showed efficiency of 57.1%, partial effective rate of 28.6%, and inefficiency of 14.3%. the infusion effects was not significanly different between the two groups, and no hemolytic transfusion reaction occurred. In the hormone-treated group, the complete remission rate was 15.2%, the partial remission rate was 63.6%, and the ineffective rate was 21.2%. Among them, the side effects appeared in 2 patients after using hormones.

CONCLUSION

When AIHA patients need blood transfusion, use the same type of non-washed red blood cells or homologous washed cells is relatively safe, and the difference in efficacy is not significant. The partial remission of patients received hormone therapy is much higher than that of red blood cell transfusion, but the side effects easily happen.

摘要

目的

评估不同类型红细胞(RBC)输注及激素疗法治疗自身免疫性溶血性贫血(AIHA)患者的疗效及安全性。

方法

回顾性收集并分析我院2014年至2018年收治的40例AIHA患者的临床资料及血清学特征。根据交叉配血后最小不相容RBC输注原则评估不同类型RBC输注及激素疗法的疗效及安全性。

结果

40例AIHA患者中,女性病例多于男性病例,继发性AIHA病例多于原发性AIHA病例,且以温抗体型为主。11例AIHA患者接受了26次最小不相容红细胞输注。总有效率为46.2%,部分有效率为23.1%,总无效率为30.8%。其中,同型非洗涤红细胞组有效率为42.1%,部分有效率为21.1%,无效率为36.8%;同型洗涤红细胞组有效率为57.1%,部分有效率为28.6%,无效率为14.3%。两组输注效果差异无统计学意义,且未发生溶血性输血反应。激素治疗组完全缓解率为15.2%,部分缓解率为63.6%,无效率为21.2%。其中,2例患者使用激素后出现副作用。

结论

AIHA患者需要输血时,使用同型非洗涤红细胞或同型洗涤红细胞相对安全,疗效差异不显著。接受激素治疗的患者部分缓解率远高于红细胞输注,但容易出现副作用。

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