红细胞输血在温暖型自身免疫血液溶解性贫血中
A Salama1, H Berghöfer, C Mueller-Eckhardt
1Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany.
Lancet (London, England)
|December 19, 1992
概括
对于患有热型自身免疫血清性贫血 (AIHA) 的患者来说,输血可能是安全的. 这项研究发现,与其他患者相比,接受输血的AIHA患者的合免疫和血液溶解风险较低.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 输血医学 输血医学
背景情况:
- 热型自身免疫血清性贫血 (AIHA) 经常被认为是输血的禁忌,因为人们担心血液溶解和异免疫的增加.
- 现有的临床实践指南一般建议AIHA患者不要输血.
- 在AIHA中输血治疗的安全性和有效性仍然是争论的主题.
研究的目的:
- 为了追溯分析热型AIHA患者输血的结果.
- 评估AIHA患者的合免疫和不良血液溶解输血反应的发生率.
- 将AIHA患者的输血风险与其他多输血患者组的输血风险进行比较.
主要方法:
- 追溯分析79名多输血患者 (74名成年人,5名儿童) 的数据,检测到可检测到的温暖自身抗体和贫血.
- 患者在输血后被跟踪了6个月至12年.
- 评估包括监测非免疫和血液溶解活性的变化.
主要成果:
- 在接受输血用于去补偿的AIHA的53名AIHA患者中,没有一个患有输血相关的合免疫或血液溶解显著增加.
- 即使在输血红细胞由于自身抗体而导致血清不相容的情况下,这种情况也是如此.
- 在26名没有AIHA的患者中,他们因其他原因接受了输血,其中23名患有alloantibodies和/或自身抗体.
结论:
- 这些发现挑战了传统的观点,即在热型AIHA中,输血本质上是危险的.
- 在AIHA患者中,合免疫和不良血溶性输血反应的发生率似乎低于其他多输血人群.
- 输血疗法可能是一个可行的选择,用于管理AIHA患者选择的贫血.
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