[在重复输血儿童中延迟血液溶解输血反应的分析]
Li-Lan Gao1, Meng-Xing Lyu1, Shu-Xia Wang1
1Department of Blood Transfusion, Kunming Children's Hospital, Kunming 650228, Yunnan Province, China.
Zhongguo shi yan xue ye xue za zhi
|February 28, 2025
概括
晚期溶血输血反应发生在0.15%的儿科输血中,主要发生在患有沙拉西米亚或白血病的儿童中. 预防性抗原匹配输血对于预防这些反应和确保患者安全至关重要.
科学领域:
- 儿科血液学 儿科血液学
- 输血医学 输血医学
- 免疫学 免疫学 免疫学
背景情况:
- 延迟血液溶解输血反应 (DHTR) 在接受重复输血的儿科患者中构成风险.
- 了解DHTR的特征对于改善儿童输血安全至关重要.
研究的目的:
- 分析儿童DHTR的临床特征和血清学概况.
- 为儿童患者预防和管理DHTR建立科学基础.
主要方法:
- 从15164名接受过输血的儿童中对23例儿科DHTR病例的回顾性分析.
- 输血前后实验室测试的比较,包括血清学,血液计数和生物化学.
- 对诊断的评估和对抗体消失时间的评估.
主要成果:
- DHTR发病率为0.15%,主要在患有沙拉西米亚和急性白血病的儿童中,特别是在超过20次输血后.
- 贫血 (86.96%) 是主要症状;低血压和呼吸障碍发生在4.35%.
- 直接抗球蛋白试验 (91.30%) 和红细胞抗体试验 (100%) 呈阳性. Rh和Kidd系统是常见的抗体. 输血后实验室发现了显著的差异 (P<0.05).
结论:
- 在重复输血的儿童中,DHTR发生率显著,具有长时间的抗体持久性.
- 建议用ABO,Rh和Kidd抗原匹配血液进行预防性输血.
- 抗原阴性血液匹配对于诊断的DHTR病例的管理至关重要.
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