CAJ | 학술논문

目的：研究血液病患者运用输注辐照血小板后免疫参数的变化情况,同时研究两者之间的相关性。方法：我院选择2010年6月~2012年6月间进行多次输血的119例恶性血液病患者,将其随机分为两组,对照组的132例患者输入普通机血小板,观察组的106例患者输入r辐照机采血小板,比较两组患者输注血液后的有效率以及不良反应发生率,对输血前后补体(C3、C4)、免疫球蛋白(Ig G、Ig M、IgA )、循环免疫复合体( CIC )、C反应蛋白的变化进行检测。对无效输注患者的免疫参数特点进行分析。结果：观察组的患者输注机采血小板后血清免疫球蛋白(IgG、IgM)、补体(C3、C4)、CIC的变化不大(P>0.05)；对照组患者的各项指标明显升高(P<0.05)；两组患者进行输血后CRP均显著升高,而IgA均未见明显改变。观察组患者的输注有效率达到84.9%,而对照组的输注有效率为56.1%,差异显著有统计学意义,输血后出现不良反应的几率也显著的降低。同时分析对血小板输注无效的患者,进行输血前血清免疫球蛋白(IgG、IgM)、补体(C3、C4)、CIC存在异常的患者数量较多,PTR患者在进行输血后体液免疫指标升高的更加显著(P<0.05)。结论：免疫球蛋白(IgG、IgM)、补体(C3、C4)、CIC及CRP都有可能对血小板的无效输注产生影响,输注r辐照机采血小板能够在一定程度上降低患者的体液免疫反应,有效的提高输注效率。
목적：연구혈액병환자운용수주복조혈소판후면역삼수적변화정황,동시연구량자지간적상관성。방법：아원선택2010년6월~2012년6월간진행다차수혈적119례악성혈액병환자,장기수궤분위량조,대조조적132례환자수입보통궤혈소판,관찰조적106례환자수입r복조궤채혈소판,비교량조환자수주혈액후적유효솔이급불량반응발생솔,대수혈전후보체(C3、C4)、면역구단백(Ig G、Ig M、IgA )、순배면역복합체( CIC )、C반응단백적변화진행검측。대무효수주환자적면역삼수특점진행분석。결과：관찰조적환자수주궤채혈소판후혈청면역구단백(IgG、IgM)、보체(C3、C4)、CIC적변화불대(P>0.05)；대조조환자적각항지표명현승고(P<0.05)；량조환자진행수혈후CRP균현저승고,이IgA균미견명현개변。관찰조환자적수주유효솔체도84.9%,이대조조적수주유효솔위56.1%,차이현저유통계학의의,수혈후출현불량반응적궤솔야현저적강저。동시분석대혈소판수주무효적환자,진행수혈전혈청면역구단백(IgG、IgM)、보체(C3、C4)、CIC존재이상적환자수량교다,PTR환자재진행수혈후체액면역지표승고적경가현저(P<0.05)。결론：면역구단백(IgG、IgM)、보체(C3、C4)、CIC급CRP도유가능대혈소판적무효수주산생영향,수주r복조궤채혈소판능구재일정정도상강저환자적체액면역반응,유효적제고수주효솔。
Objective:To study the changes of blood in patients with the use of transmission and immune parameters of platelet infusion after irradiation, and study the correlation between the two.Method:In our hospital from 2010 June to choose multiple blood transfusions for~2012 year in June 119 cases of malignant blood disease patients, which were randomly divided into two groups, 132 patients in the control group the input common machine of platelet, the observation group of 106 patients with type R irradiation aphaeresis platelets, compared two groups of patients after the infusion of blood the incidence of adverse reactions to transfusion efficiency and, before and after the complement (C3, C4), immunoglobulin's (Ig G, Ig M, IgA), circulating immune complex (CIC), to detect changes of C reactive protein. To analyze the invalid transmission characteristics in patients with immune parameters of injection.Results:The group of patients serum immunoglobulin platelet injection machine (IgG, IgM), complement (C3, C4), the CIC changes little (P>0.05);the index of group were significantly increased (P<0.05);two patients were transfused after CRP were significantly increased, while IgA had no obvious change. To observe the infusion group with efficiency up to 84.9%, while the control group, the infusion rate was 56.1%, significant difference was statistically significant, the probability of adverse reactions occur after blood transfusion was also significantly reduced. At the same time analysis of platelet transfusion refractoriness transfusion patients, serum immunoglobulin (IgG, IgM), complement (C3, C4), CIC has many patients with abnormal number of PTR patients after blood transfusion, the humeral immune index increased more significantly (P<0.05).Conclusion:The immune globulin (IgG, IgM), complement (C3, C4), CIC and CRP are likely to affect the ineffective platelet transfusion, infusion of R irradiation aphaeresis platelets can reduce humeral immune responses in patients in a certain extent, effectively improve the infusion efficiency.