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在具有限制性或自由性输血策略的患者中,输血相关的不良事件. 对MINT试验的分析

Shahab Ghafghazi¹, Lynne Uhl^2,3, Brandon Herbert^4,5,6

¹Department of Medicine, Division of Cardiology, University of Louisville, Louisville, Kentucky, USA.

|November 27, 2025

概括

在心肌梗塞患者中,自由的红细胞输血策略导致了更多的输血相关不良事件 (TRAE),而不是限制性策略. 然而,TRAE的增加并没有超过与限制性输血相关的心肌梗塞或死亡的风险.

科学领域:

心脏病学心脏病学
血液学血液学血液学
关键护理医学关键护理医学

背景情况:

与输血相关的不良事件 (TRAE) 是心肌梗塞患者的一个担忧.
心肌缺血和输血 (MINT) 试验比较了限制性与自由的红细胞 (RBC) 输血策略.

研究的目的:

量化和比较TRAE在患有心肌梗塞的成年患者中的频率.
在接受限制性与自由性红细胞输血策略的患者中评估TRAE.

主要方法:

从MINT试验中分析TRAE数据.
临床场所报告了主要的TRAE,包括输血相关的急性肺损伤,输血相关的循环过载等.
每个患者的TRAE率和每100个输血的红细胞单位的TRAE率计算.

主要成果:

自由输血组的总体TRAE率比限制性组的总体TRAE率高 (100名患者中有2.80人),比限制性组的总体TRAE率高 (100名患者中有0.51人).
主要TRAE的发病率在自由派手臂 (100名患者中的1.99人) 与限制派手臂 (100名患者中的0.51人) 中也较高.
当每100个红细胞单位正常化时,手臂之间主要TRAE率的差异在统计学上并不显著.

结论:

主要的TRAE率较低,但随着自由的输血策略而增加,与输血的红细胞单位成比例.
在自由派手臂中较高的TRAE比率并没有抵消在限制派手臂中观察到的心肌梗塞或死亡风险增加.

关键词:

剧烈的血溶性输血反应过敏性输血反应过敏性输血反应发烧性非溶血反应发烧性非溶血反应心脏衰竭是因为心脏衰竭.与输血相关的主要不良事件.输血相关的循环过载 (TACO)与输血相关的败血症与输血相关的急性肺损伤 (TRALI)与输血相关的不良事件疹性输血反应反应的发生.

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