Influence of erythrocyte immune history on transfusion effect of patients with hematological diseases
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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。
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关键词:
- 红细胞免疫史 /
- 输注效果 /
- Logistic回归分析 /
- 交互作用
Abstract: Objective:To investigate the influence of erythrocyte immune history on transfusion effect of patients with hematological diseases.Method:A retrospective analysis including 433 cases in Department of Hematology in our hospital from June 2017 to March 2018 was conducted.Transfusion effect was the dependent variable,while previous erythrocyte transfusion volume,gender,age,pregnancy frequency,clinical diagnosis and blood product 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 volume and the number of pregnancies.There was a significant difference in the unsuccessful rate of different clinical diagnosis.②Logistic regression results showed that 10-19 bags,more than 20 bags,pregnancy frequency were positively 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,10-19 bags and more than 20 bags were positively associated 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 20 bags 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,10-19 bags by pregnancy frequency and more than 20 bags 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 were positively associated with unsuccessful transfusion.Erythrocyte immune history was a risk factor for transfusion failure in patients with hematological diseases. -
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