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白细胞去除术作为预防内脏利什曼病输血传播的控制措施。

Leukoreduction as a control measure in transfusion transmission of visceral leishmaniasis.

机构信息

Laboratory of Hematological Research, Triângulo Mineiro Federal University, Uberaba, Brazil.

Department of Health of Government of the State of Ceará, Hemoce - Center for Hematology and Hemotherapy of the State of Ceará, Fortaleza, Brazil.

出版信息

Transfusion. 2023 May;63(5):1044-1049. doi: 10.1111/trf.17308. Epub 2023 Mar 17.

Abstract

BACKGROUND

Asymptomatic visceral leishmaniasis (VL) infection is a risk for transfusion safety. Leukoreduction has been an alternative for the prevention of some blood-borne diseases, including VL. This study aimed to evaluate the role of leukoreduction of cellular blood components as a control measure for transfusional VL transmission.

RESEARCH DESIGN AND METHODS

A total of 161 polytransfused patients with non-leukoreduced blood components (HNL), 95 polytransfused with leukoreduced blood components (LH), and 202 non-transfused (NT) from endemic regions for VL and with a similar epidemiological profile. The detection of antibodies against VL was performed by ELISA and the presence of the parasite was investigated by real-time PCR. Statistical significance was defined as p < .05.

RESULTS

When comparing three groups, ELISA results were statistically significant (p = .0065). The residual analysis of ELISA showed statistically significant for the HNL group compared to the general group (p = .002; OR: 5.6; CI: 1.7-25.8), demonstrating that individuals who received non-leukoreduced transfusions are five times more likely to acquire Leishmania infantum infection than the general.

DISCUSSION

Higher prevalence in the group with HNL and low prevalence in those who received LH, similar to NT patients, highlight the risk of transfusional VL transmission and reinforce the role of leukoreduction in its prevention.

摘要

背景

无症状内脏利什曼病(VL)感染是输血安全的一个风险。白细胞减少法已成为预防一些血源性疾病的替代方法,包括 VL。本研究旨在评估细胞血液成分白细胞减少法作为预防输血传播 VL 的控制措施的作用。

研究设计和方法

共有 161 名接受非白细胞减少血液成分(HNL)的多输血患者、95 名接受白细胞减少血液成分(LH)的多输血患者和 202 名来自 VL 流行地区且具有相似流行病学特征的未输血(NT)患者。通过 ELISA 检测针对 VL 的抗体,通过实时 PCR 检测寄生虫的存在。统计学意义定义为 p < .05。

结果

当比较三组时,ELISA 结果具有统计学意义(p = .0065)。ELISA 的残差分析显示,与一般组相比,HNL 组具有统计学意义(p = .002;OR:5.6;CI:1.7-25.8),表明接受非白细胞减少输血的个体感染利什曼原虫的可能性是一般人群的五倍。

讨论

HNL 组的患病率较高,LH 组的患病率较低,与 NT 患者相似,这突出了输血传播 VL 的风险,并强调了白细胞减少法在预防中的作用。

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