不同的紅細胞制品輸注治療兒童重型地中海貧血的不良反應分析

陳建萍

【摘要】 目的：探究不同的紅細胞制品輸注治療兒童重型地中海貧血的不良反應。方法：選取筆者所在醫院兒童重型地中海貧血96例，隨機數字表法分為A組、B組、C組。A組給予普通紅細胞輸注，B組給予年輕紅細胞輸注，C組給予去白紅細胞輸注。對比三組不良反應發生情況及治療前后檢測三組T細胞亞群（T3、T4、T4/T8）、自然殺傷細胞（NK）細胞活性。結果：B組、C組FNHTR、輸血性鐵過載、免疫介導的輸血不良反應發生率較A組低（P<0.05）;治療后B組、C組T3、T4、T4/T8、NK細胞活性較治療前高（P<0.05）;治療后B組、C組T3、T4、T4/T8、NK細胞活性較A組高（P<0.05）;輸注后B組、C組Hb提升量高于A組（P<0.05）。結論：兒童重型地中海貧血采用年輕紅細胞輸注或去白紅細胞輸注治療，可降低不良反應發生率，改善機體細胞免疫功能，提高輸注效果。

【關鍵詞】 兒童重型地中海貧血; 普通紅細胞; 去白紅細胞; 年輕紅細胞

doi：10.14033/j.cnki.cfmr.2019.06.04 文獻標識碼 A 文章編號 1674-6805（2019）06-0-03

Analysis of Adverse Reactions in Children with Severe Thalassemia Treated with Different Red Blood Cell Products/CHEN Jianping.//Chinese and Foreign Medical Research，2019，17（6）：-10

【Abstract】 Objective：To investigate the adverse reactions of different red blood cell products infusion for the treatment of severe thalassemia in children.Method：Ninety-six patients with severe thalassemia in our hospital were enrolled in this study.The random number table method was divided into group A，group B and group C.Group A was given a normal red blood cell transfusion，group B was given a red blood cell transfusion，and group C was given a white blood cell infusion.The activity of the three groups of T cells （T3，T4，T4/T8） and natural killer cells （NK） were compared before and after treatment.Result：The incidence of FNHTR，transfusion iron overload and immune-mediated transfusion adverse reactions in group B and C were lower than those in group A （P<0.05）.The levels of T3，T4，T4/T8 and NK cell activities in group B and C after treatment were higher than those before treatment （P<0.05）.The levels of T3，T4，T4/T8 and NK cells in group B and group C were higher than those in group A after treatment （P<0.05）.After treatment，the increase of Hb in group B and group C was higher than that in group A （P<0.05）.Conclusion：Children with thalassemia major are treated with young red blood cell transfusion or white blood cell infusion，which can reduce the incidence of adverse reactions and improve the cellular immune function，and improve the infusion effect.

【Key words】 Children with thalassemia; Common red blood cells; White erythrocytes; Young red blood cells

First-authors address：The Frist Peoples Hospital of Honghe State，Mengzi 661100，China

地中海貧血為單基因遺傳病，為熱帶、亞熱帶地區高發疾病[1]。有關數據顯示，全球攜帶地中海貧血基因人數約為2.7億，每年降生的地中海貧血患兒約10萬[2]。我國廣西、廣東為地中海貧血高發區，有研究表明，廣東地區人群中10%以上攜帶地中海貧血基因[3]。目前，治療地中海貧血的主要方法為輸血。但長期輸血可引起體內產生多種輸血抗體，且存在多種并發癥[4-5]。相關研究表明，針對重型地中海貧血患兒，去白紅細胞輸注可降低減少FNHTR，降低不良反應的發生率及免疫功能損害[6]。因此，選擇輸血反應小、效果好、針對性強的紅細胞制品對兒童重型地中海貧血尤為重要。本研究選取筆者所在醫院96例兒童重型地中海貧血，分組研究不同的紅細胞制品輸注治療兒童重型地中海貧血的不良反應，研究如下。