【摘要】 目的探讨直接抗球蛋白试验(DAT)阳性患者红细胞输注效果的影响因素。方法选取输注红细胞的192例DAT阳性患者作为研究对象,根据治疗效果的不同分为输注有效组和输注无效组,比较2组患者的一般情况、原发病性质、血液制品情况、伴随症状等,并将差异具有统计学意义的因素纳入多因素Logistics回归分析,探讨患者红细胞输注效果的影响因素。结果 192例DAT阳性患者中,红细胞输注无效者37例;既往输血次数、是否恶性疾病、血液制品储存时间、血液制品品种、是否伴随感染、是否伴随发热、是否伴随肝脾肿大均与DAT阳性患者红细胞输注效果相关(P<0.05);多因素Logistic回归分析显示,既往输血次数(OR=2.678)、恶性疾病(OR=3.485)、血液制品储存时间(OR=2.764)、血液制品品种(OR=2.602)、发热(OR=2.951)均为DAT阳性患者红细胞输注效果的独立影响因素(P<0.05)。结论既往输血次数、原发病性质、血液制品储存时间、血液制品品种、伴随发热均可对DAT阳性患者红细胞输注效果产生影响,故临床应针对上述因素制定针对性输血策略,以改善DAT阳性患者的输血治疗效果。更多还原

【Abstract】 Objective To explore influencing factors of red blood cell transfusion effect in patients with positive direct antiglobulin test(DAT). Methods A total of 192 positive DAT patients who received red blood cell transfusion were selected as study objects, and were divided into effective infusion group and ineffective infusion group according to the therapeutic effects. The general situations, nature of primary disease, blood products situation and accompanying symptoms of the two groups were investigated and analyzed, and the statistical factors with statistical differences were included in the Logistic analysis. The influencing factors of red blood cell transfusion were explored. Results Among the 192 positive DAT patients, 37 had no effects on red blood cell infusion. The number of previous blood transfusion, malignant diseases, storage time of blood products, blood product varieties, accompanying infection conditions, fever, hepatosplenomegaly were closely related to the effects of positive DAT patients′ red blood cell transfusion(P<0.05). Multivariate Logistic regression analysis showed that there were five factors influencing the transfusion effect of positive DAT patients: previous transfusion times(OR=2.678), malignant diseases(OR=3.485), storage time of blood products(OR=2.764), blood products varieties(OR=2.602) and fever(OR=2.951). Conclusion The number of previous blood transfusions, nature of primary disease, storage time of blood products, varieties of blood products and fever can affect the effect of red blood cell transfusions in positive DAT patients. Therefore, the blood transfusion strategy should be made according to the above factors to improve thetreatment effect of positive DAT patients.更多还原