摘要
目的:探讨红细胞免疫史对血液病患者红细胞输注效果的影响。方法:对2017-06—2018-03输血患者433例进行回顾性分析。以是否输注有效为因变量,以既往红细胞输血量、性别、年龄、妊娠次数、临床诊断、血制品贮存时间为自变量,采用多因素Logistic回归分析分层研究既往红细胞输血量、妊娠次数及二者交互作用对红细胞输注无效发生风险的影响。结果:(1)血液科输注无效率为30.3%(131/433),其中男性无效率为34.3%(86/251),高于女性无效率24.7%(45/182);输注无效率随着既往红细胞输注量和妊娠次数的增加而升高;不同临床诊断输注无效率差异有统计学意义。(2)红细胞免疫史影响输血效果的多因素Logistic回归结果显示:既往输血量10～19袋、≥20袋、妊娠次数与输注无效呈正相关,OR值分别为3.89(95%CI:1.73～8.74)、7.79(95%CI:3.42～17.78)、2.35(95%CI:1.60～3.46)。男性既往输血量10～19袋、≥20袋与输注无效呈正相关,OR值分别为4.86(95%CI:1.76～13.40)、7.89(95%CI:2.75～22.61)。女性既往输血量≥20袋、妊娠次数与输注无效呈正相关,OR值分别为8.87(95%CI:2.01～39.03)、7.72(95%CI:3.27～18.22);交互作用后10～19袋×妊娠次数、≥20袋×妊娠次数与输注无效呈正相关,OR值分别为2.79(95%CI:1.62～4.79)、4.52(95%CI:2.44～8.34)。结论:既往输血量增加、妊娠次数增加,且针对女性患者而言二者的交互作用均与输注无效正相关,红细胞免疫史是血液病患者发生输血无效的危险因素。
Objective:To investigate the influence of erythrocyte immune history on transfusion effect of pa-tients with hematological diseases.Method:A retrospective analysis including 433cases in Department of Hematol-ogy in our hospital from June 2017to March 2018was conducted.Transfusion effect was the dependent variable,while previous erythrocyte transfusion volume,gender,age,pregnancy frequency,clinical diagnosis and blood prod-uct storage time were independent variables.Multivariable logistic regression was used to study the influence of previous erythrocyte transfusion volume,pregnancy frequency and the interaction between the two factors on the risk of unsuccessful transfusion.Result:①The rate of unsuccessful transfusion was 30.3% (131/433).The rate of unsuccessful transfusion in male was 34.3% (86/251 ), which was higher than that of female 24.7% (45/182).The rate of unsuccessful transfusion increased with the increase of the amount of previous erythrocyte transfusion vol-ume and the number of pregnancies.There was a significant difference in the unsuccessful rate of different clinical diagnosis.②Logistic regression results showed that 10-19bags,more than 20bags,pregnancy frequency were posi-tively associated with unsuccessful transfusion,with ORs of 3.89 (95% CI:1.73-8.74 ), 7.79 (95% CI:3.42-17.78 ), 2.35 (95% CI:1.60-3.46 ), respectively.For men,10-19bags and more than 20bags were positively associ-ated with unsuccessful transfusion,with ORs of 4.86 (95% CI:1.76-13.40 ), 7.89 (95% CI:2.75-22.61).For women,more than 20bags and pregnancy frequency were positively associated with unsuccessful transfusion,with ORs of 8.87 (95% CI:2.01-39.03 ), 7.72 (95% CI:3.27-18.22).After interaction,10-19bags by pregnancy fre-quency and more than 20bags by pregnancy frequency were positively associated with unsuccessful transfusion,with ORs of 2.79 (95% CI:1.62-4.79 ), 4.52 (95% CI:2.44-8.34).Conclusion:Increased previous erythrocyte transfusion volume,pregnancy frequency and the interaction between the two factors for women
作者
李君
张慧
侯金友
邹红蕊
张秀梅
张晓磊
卢焱坤
孙超
LI Jun;ZHANG Hui;HOU Jinyou;ZOU Hongrui;ZHANG Xiumei;ZHANG Xiaolei;LU Yankun;SUN Chao(Department of Blood Transfusion,Blood Transfusion Branch of Kailuan General Hospital,Tangshan,063000,China;Tangshan Central Blood Station)
出处
《临床血液学杂志（输血与检验）》
CAS
2018年第6期953-956,共4页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
