不同的红细胞制品输注治疗儿童重型地中海贫血的不良反应分析

陈建萍

【摘要】 目的：探究不同的红细胞制品输注治疗儿童重型地中海贫血的不良反应。方法：选取笔者所在医院儿童重型地中海贫血96例，随机数字表法分为A组、B组、C组。A组给予普通红细胞输注，B组给予年轻红细胞输注，C组给予去白红细胞输注。对比三组不良反应发生情况及治疗前后检测三组T细胞亚群（T3、T4、T4/T8）、自然杀伤细胞（NK）细胞活性。结果：B组、C组FNHTR、输血性铁过载、免疫介导的输血不良反应发生率较A组低（P<0.05）;治疗后B组、C组T3、T4、T4/T8、NK细胞活性较治疗前高（P<0.05）;治疗后B组、C组T3、T4、T4/T8、NK细胞活性较A组高（P<0.05）;输注后B组、C组Hb提升量高于A组（P<0.05）。结论：儿童重型地中海贫血采用年轻红细胞输注或去白红细胞输注治疗，可降低不良反应发生率，改善机体细胞免疫功能，提高输注效果。

【关键词】 儿童重型地中海贫血; 普通红细胞; 去白红细胞; 年轻红细胞

doi：10.14033/j.cnki.cfmr.2019.06.04 文献标识码 A 文章编号 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

地中海貧血为单基因遗传病，为热带、亚热带地区高发疾病[1]。有关数据显示，全球携带地中海贫血基因人数约为2.7亿，每年降生的地中海贫血患儿约10万[2]。我国广西、广东为地中海贫血高发区，有研究表明，广东地区人群中10%以上携带地中海贫血基因[3]。目前，治疗地中海贫血的主要方法为输血。但长期输血可引起体内产生多种输血抗体，且存在多种并发症[4-5]。相关研究表明，针对重型地中海贫血患儿，去白红细胞输注可降低减少FNHTR，降低不良反应的发生率及免疫功能损害[6]。因此，选择输血反应小、效果好、针对性强的红细胞制品对儿童重型地中海贫血尤为重要。本研究选取笔者所在医院96例儿童重型地中海贫血，分组研究不同的红细胞制品输注治疗儿童重型地中海贫血的不良反应，研究如下。