摘要
目的分析血浆置换联合连续性血液净化技术在再生障碍性贫血(AA)患者中的应用效果。方法选取2017年1月至2021年1月淮安市第二人民医院、淮安市第一人民医院收治的78例AA患者作为研究对象,按照血液净化方法不同分为两组,每组39例。其中,对照组采用连续性血液净化技术治疗,试验组在对照组治疗的基础上给予血浆置换治疗。比较两组治疗前后血常规指标[白细胞(WBC)计数、中性粒细胞计数、淋巴细胞比率、血红蛋白(Hb)、血小板(PLT)计数、网织红细胞(ReT)计数]、转铁蛋白饱和度、血清铁蛋白以及炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平变化,以及临床疗效和不良反应发生情况。结果不同时点间、组间WBC计数、中性粒细胞计数、淋巴细胞比率、Hb、PLT计数、ReT计数、转铁蛋白饱和度、血清铁蛋白水平的主效应差异有统计学意义(P<0.01),时点间与组间存在交互作用(P<0.01)。与治疗前相比,治疗后两组的WBC计数、中性粒细胞计数、Hb、PLT计数、ReT计数均升高,且试验组高于对照组(P<0.05);淋巴细胞比率、转铁蛋白饱和度、血清铁蛋白水平均降低,且试验组低于对照组(P<0.05)。不同时点间、组间IL-6、TNF-α水平的主效应差异有统计学意义(P<0.01),时点间与组间存在交互作用(P<0.01)。与治疗前相比,治疗后两组的IL-6、TNF-α水平均降低,且试验组低于对照组(P<0.05)。试验组的总有效率高于对照组[89.74%(35/39)比66.67%(26/39)](P<0.01)。试验组的总不良反应发生率低于对照组[7.69%(3/39)比28.21%(11/39)](P<0.05)。结论与单独应用连续性血液净化技术相比,血浆置换联合连续性血液净化技术更有利于提高AA临床疗效,改善血常规及血清铁指标,降低炎症反应,且安全性佳。
Objective To analyze the applicative effect of plasma exchange combined with continuous blood purification technology in patients with aplastic anemia(AA).Methods A total of 78 AA patients admitted to Huai′an Second People′s Hospital and Huai′an First People′s Hospital from Jan.2017 to Jan.2021 were included,and divided into two groups according to the blood purification method,with 39 cases in each group.The control group was treated with continuous blood purification technology,and the test group was treated with plasma exchange on the basis of the treatment of the control group.Comparing the two groups before and after treatment the blood routine index[white blood cells(WBC)count,neutrophil count,lymphocyte ratio,hemoglobin(Hb),platelet count(PLT),reticulocyte(ReT)count],serum ferritin,transferrin saturation and inflammatory factor[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]level,and the clinical efficacy and adverse reactions of the two groups were compared.Results The main effects of WBC,neutrophil count,lymphocyte percentage,Hb,PLT,transferrin saturation,ReT and serum ferritin levels were significantly different between different time points and groups(P<0.01),and there were interactions between time points and groups(P<0.01).Compared with before treatment,the levels of WBC,neutrophil count,Hb,PLT and ReT in the two groups were increased after treatment,and the test group was higher than the control group(P<0.05);lymphocyte percentage,transferrin saturation,serum ferritin levels were decreased,and the test group was lower than the control group(P<0.05).The main effect differences of IL-6 and TNF-αlevels between different time points and groups were statistically significant(P<0.01),and there was interaction between time points and groups(P<0.01).Compared with before treatment,the levels of IL-6 and TNF-αin the two groups were decreased after treatment,and the test group was lower than the control group(P<0.05).The total effective rate of the test group was higher than that of the control group[89.74%(35/39)vs 66.67%(26/39)](P<0.01).The incidence of total adverse reactions in thetest group was lower than that in the control group[7.69%(3/39)vs 28.21%(11/39)](P<0.05).Conclusion Compared with continuous blood purification technology alone,plasma exchange combined with continuous blood purification technology is more conducive to improving the clinical efficacy of AA,improve blood routine and serum iron index,reduce inflammatory response,and has good safety.
作者
孙梦霞
程莹
李飞云
秦彩虹
SUN Mengxia;CHENG Ying;LI Feiyun;QIN Caihong(Blood Purification Center,Huai′an Second People′s Hospital/the Affiliated Huai′an Hospital of Xuzhou Medical University,Huai′an 223002,China;Department of Rehabilitation,Huai′an First People′s Hospital,Huai′an 223300,China)
出处
《医学综述》
CAS
2022年第9期1842-1846,共5页
Medical Recapitulate
