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目的探讨去白细胞输血对恶性血液病患者免疫功能的影响。方法选取永城市人民医院2014年5月—2016年2月收治的恶性血液病患者101例,随机分为观察组51例和对照组50例。观察组患者给予去白细胞输血,对照组患者行常规输血。观察比较两组患者治疗前后细胞免疫变化情况[人补体片段3b受体(C3br)率、自然杀伤细胞(NK)活性及T淋巴细胞亚群(T_3细胞分数、T_4细胞分数、T_8细胞分数、T_4/T_8细胞比值)及非溶血性发热(NHFTR)发生情况,并观察比较两组患者治疗前后体温变化情况及体温差、体液免疫[免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白E(IgE)]情况。结果治疗前,两组患者C3br率、NK活性及T_3细胞分数、T_4细胞分数、T_8细胞分数、T_4/T_8细胞比值比较,差异无统计学意义(P>0.05);治疗后,观察组患者T_3细胞分数低于对照组,C3br率、NK活性及T_4细胞分数、T_4/T_8细胞比值高于对照组(P<0.05),但两组患者T_8细胞分数比较,差异无统计学意义(P>0.05)。观察组患者NHFTR发生率低于对照组(P<0.05)。治疗前,两组患者体温比较,差异无统计学意义(P>0.05);治疗后,观察组患者体温低于对照组(P<0.05);观察组患者体温平均差低于对照组(P<0.05)。治疗前,两组患者IgG、IgA、IgM、IgE水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者IgG、IgA、IgM、IgE水平高于对照组(P<0.05)。结论去白细胞输血应用于恶性血液病患者可有效改善患者的细胞免疫及体液免疫功能,还可明显降低发热及NHFTR发生风险。
Objective To investigate the effect of leukocyte transfusion on immune function in patients with hematologic malignancies. Methods 101 patients with malignant hematological diseases admitted to Yongcheng People’s Hospital from May 2014 to February 2016 were randomly divided into observation group (n = 51) and control group (n = 50). Patients in the observation group were given leukocyte transfusion and patients in the control group received routine blood transfusion. The changes of cellular immunity before and after treatment were observed and compared (C3br rate, NK activity and T_3 cell fraction, T_4 cell fraction, T_8 cell fraction, T_4 / T-8 cell ratio) and non-hemolytic fever (NHFTR). The changes of body temperature and body temperature before and after treatment were compared between two groups. The humoral immunity [IgG, IgA, Immunoglobulin M (IgM), immunoglobulin E (IgE)] cases. Results Before treatment, there was no significant difference in C3br rate, NK activity and T_3 cell fraction, T_4 cell fraction, T_8 cell fraction and T_4 / T_8 ratio in both groups (P> 0.05). After treatment, T_3 The cell fraction was lower than the control group, C3br rate, NK activity and T4 cell fraction, and the ratio of T_4 / T_8 cells was higher than that of the control group (P <0.05). However, there was no significant difference in T8 cell fraction between the two groups ). The incidence of NHFTR in observation group was lower than that in control group (P <0.05). Before treatment, there was no significant difference in body temperature between the two groups (P> 0.05). After treatment, the body temperature in the observation group was lower than that in the control group (P <0.05), and the mean body temperature difference in the observation group was lower than that in the control group (P < 0.05). Before treatment, the levels of IgG, IgA, IgM and IgE in the two groups had no significant difference (P> 0.05); After treatment, the levels of IgG, IgA, IgM and IgE in the observation group were higher than those in the control group . Conclusion The application of leukocyte transfusion in patients with hematologic malignancies can effectively improve the cellular immunity and humoral immunity in patients, and can significantly reduce the fever and the risk of NHFTR.