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临床输血与检验

临床输血与检验 ›› 2018, Vol. 20 ›› Issue (4): 368-370.DOI: 10.3969/j.issn.1671-2587.2018.04.010

• 临床输血 • 上一篇    下一篇

输血相关急性肺损伤的危险因素及预后分析

张锐东,张志发,李军   

  1. 510080 广州,广东省医学科学院,广东省人民医院输血科
  • 收稿日期:2018-02-11 出版日期:2018-08-20 发布日期:2018-08-14
  • 作者简介:张锐东（1973–）,男,广东广州人,副主任技师,学士,主要从事临床输血工作,（E-mail）443801982@163.com。

Analysis of the Risk Factors and Prognosis in Transfusion-related Acute Lung Injury

ZHANG Rui-Dong,ZHANG Zhi-Fa,LI Jun.   

  1. Guangdong Academy of Medical Sciences,Guangdong General Hospital,Guangzhou 510080
  • Received:2018-02-11 Online:2018-08-20 Published:2018-08-14

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摘要： 目的 分析输血后发生输血相关急性肺损伤（transfusion-related acute lung injury，TRALI）的相关危险因素，并探讨TRALI对预后的影响。方法 回顾2008年12月~2016年12月，以37例TRALI患者为观察组，随机抽取无TRALI发生患者58例为对照组，对比两组患者的性别、年龄及临床指标，分析可能影响TRALI发生的危险因素。结果 观察组患者的HLA抗体II、围术期输血量、总输液量、输血前休克、吸烟史、机械通气、肝脏疾病发生率均高于对照组，差异有统计学意义（P<0.05）。Logistic回归分析显示HLA抗体II、围术期输血量、输血前休克、吸烟史、肝脏疾病为TRALI发生的独立危险因素。经Log-rank检验，两组间生存率比较差异有统计学意义（χ2=49.056，P<0.05），经Kaplan-Meier法绘制生存曲线可看出，观察组生存率较低，而对照组的生存率较高。结论 输血后发生TRALI的原因与患者HLA抗体II、围术期输血量、输血前休克、吸烟史、肝脏疾病有关，发生TRALI的患者预后差。

关键词: 输血相关急性肺损伤, 输血, 危险因素, 预后

Abstract: Objective To analyze the correlative risk factors and prognosis of transfusion-related acute lung injury （TRALI）in the patients who had received blood transfusion. Methods Thirty seven patients with TRALI from 2008 to 2014 were compared with the control of 58 cases for gender，age and clinical index，and possible independent risk factors that might influence TRALI were discussed. Results Compared with the control without TRALI，risk factors for TRALI included HLA antibodies II，transfusion，shock，smoking and hepatic disorders. Patients with TRALI had a higher mortality when compared with the control （χ2=49.056，P<0.05）. Conclusion The risk factors correlated to TRALI comprised of antibodies against HLA II，blood transfusion，shock，and history of smoking and hepatic diseases. Patients with TRALI had bad prognoses. Post-operative intensive cure is the critical for avoidance of TRALI.

Key words: TRALI Transfusion, Risk factors , Prognosis

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