论文部分内容阅读
目的探讨重型β地中海贫血(TM)患者输注红细胞的疗效及红细胞保存时间对TM输血效果的影响。方法将采集后6-8 h完成白细胞过滤、血细胞比容(Hct)45%-47%、常规检测合格的血液52(人)份(400 m L/份),各自等分成2份1 U的少白红细胞(少白RBC)备用;给按研究标准纳入的52名TM患者分别输注采自同一献血者储存至d3(新鲜血)和d17(陈旧血)的少白RBC各1 U(200 m L/U),并在输血前、输血后24 h和输血后d14分别做血细胞分析。结果本组52例TM中,除10例脱落外,有42例完成研究,其血清铁蛋白(SF)为125 1.00-7406.07(中位值343 4.6)ng/m L,其中重度铁过载28例,肝大16例,脾大38例。5次检测Hb(g/L)依次为80.9+16.1、100.7+14.5、83.4+12.8、100.9+12.2和82.1+12.6。TM患者输新鲜血和陈旧血后每10 kg体重Hb(g/L)分别提升33.0+8.5和29.4+10.0(P<0.05),输血后d14 Hb(g/L)分别下降30.4+14.3和32.1+11.6(P>0.05)。新鲜血输注后Hb降低量与SF和重度铁过载呈正相关关系;陈旧血输注后Hb降低量与肝大呈正相关关系。结论铁超载、肝脏增大影响TM患者输血的效果。保存时间短的红细胞(新鲜血)提升Hb的幅度大于保存时间长的红细胞(陈旧血)。
Objective To investigate the effects of transfusion of erythrocytes in patients with severe β thalassemia (TM) and the effect of erythrocyte preservation on TM transfusion. Methods The leukocyte filtration, hematocrit (Hct) 45% -47% and routinely tested blood 52 (human) (400 m L / part) were completed 6-8 h after the collection. (White RBC) were given to the study. Fifty-two TM patients enrolled in the study standard were infused with 1 U (200) RBCs from d3 (fresh blood) and d17 (old blood) stored in the same blood donor m L / U), and before blood transfusion, 24 h after transfusion and d14 after blood transfusion, respectively. Results In 52 cases of TM, 42 patients completed the study except for 10 cases whose serum ferritin (SF) was 125 1.00-7406.07 (median 343 4.6) ng / m L, of which 28 were severe iron overload , 16 cases of hepatomegaly, 38 cases of splenomegaly. Five tests Hb (g / L) followed by 80.9 +16.1,100.7 +14.5,83.4 +12.8,100.9 +12.2 and 82.1 +12.6. The levels of Hb (g / L) were increased by 33.0 + 8.5 and 29.4 + 10.0 (P <0.05) and the d14 Hb (g / L) decreased by 30.4 + 14.3 and 32.1 +11.6 (P> 0.05). The decrease of Hb after new blood transfusion was positively correlated with SF and severe iron overload. The decrease of Hb after old blood transfusion was positively correlated with liver enlargement. Conclusion The effects of iron overload and liver enlargement on the blood transfusion in TM patients. Short-lived red blood cells (fresh blood) elevate the magnitude of Hb by more than the long-lived red blood cells (old blood).