去白细胞输血预防非溶血性发热性输血反应的临床应用

目的：评价临床输注法去白细胞红细胞悬液和浓缩血小板预防非溶血性发热性输血反应（FNHTR）的效果。方法：选择100例肝硬化、胃溃疡和胃癌等病人输注去白细胞红细胞悬液，对照组相类似50例病人输注普通红细胞悬液。240例急慢性白血病、再生障碍性贫血、多发性骨髓瘤、血小板减少性紫癜、糖尿病、肝硬化、上消化道出血、重症肝炎、烧伤、癌症放、化疗等患者分为两组，各组120例随机接受去白细胞血小板或未去白细胞血小板悬液。观察这些患者FNHTR的发生率。结果：在100例接受去白细胞红细胞悬液的患者中未发生FNHTR，对照组50例患者中有8例发生FNHTR，发生率为16%；血小板输注的患者中，去白细胞和未去白细胞的FNHTR发生7例和25例，发生率分别为5.83%和20.83%。结论：去白细胞输血可防止或减低FNHTR的发生。

Clinical assessment of preventing febrile nonhemolytie transfusion reaction by leukocyte filtration blood transfusion

Objective To assess the clinical efficiency of preventing febrile nonhemolytic transfusion reactions (FNHTR) with transfusion of leukocyte filtration RBC and platelet concentrates. Methods 100 patients with cirrhosis of liver, gastric ulcer and cancer were selected to receive RBC concentrates with leukocyte filtration. Another 50 patients with cirrhosis of liver, gastric ulcer and cancer were selected to receive non filtered RBC concentrates. 240 patients with acute or chronic leukemia, aplastic anemia, multiple myeloma, thrombocytopenia purpura, diabetes mellitus, cirrhosis of liver, upper gastrointestinal hemorrhage, severe hepatitis, burn and cancer post radioactive or chemical treatment were divided into two group with 120 patients in each one and selected randomly to receive platelets concentrates. The incidence rates of FNHTR in all patients were investigated. Results There was no FNHTR in 100 transfusions with leukocyte filtrated RBC concentrates. 8 of 50 patients with non filtrated RBC concentrates were occurred FNHTR. The incidence of FNHTR was 16% in non filtrated transfusion. 25 and 7 patients with FNHTR occurred separately in non filtrated and filtrated platelets concentrations. The incidence of FNHTR was separately 20.83% and 5.83% in non filtrated or filtrated platelets transfusion. Conclusion Leukocyte filtration of RBC and platelet concentrates can reduce FNHTR in blood transfusion.